LE0011 Vita Care, LLC

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MMM Holdings, LLCJob Description

BUSINESS UNIT: MSO of PR, Inc. DPOSITION: SCC Physician

POSITION DESCRIPTIONThe Special Care Clinic Physician role entails organizing, directing and providing medical and health diagnostic treatment services in the special care clinic setting. She/He will be providing care for the severely chronically ill population of the MMM/PMC membership. The services provided will be personalized and intensive in order to provide improved quality of life. She/He will work with a dedicated team selected to work with this subset of our population. She/He likewise will perform tasks and duties that are required of him/her to perform.

RESPONSIBILITIES:• Provides medical patient care by interviewing, examining and treating of clinical patients in order to meet their medical needs• Diagnoses diseases, conditions and illnesses• Educates patients on wellness, prevention and early detection by providing materials and resources to the patients and families• Determines which referrals are required based on examination and patient needs• Determines level of urgency of follow-up, referral/consultation appointments• Exercises final medical judgment in all issues of health care• Prescribes medical treatment and clinical drugs to patients• Orders studies, test and ancillary services• Reviews x-ray and laboratory findings• Documents all services in patient medical record• Reviews on a regular basis long term cases that require ongoing medical attention• Consults with Medical Director and other professionals on staff as needed regarding patient care, assessment, and education issues• Participates in quality improvement, management, continuing education, and other patient care programs established by the hospital or clinic requirements• Refers patients for special types of diagnostic treatments or medical procedures and coordinates plans for treatments• Provides medical consultation to prevention, treatment, care and diagnosis of health conditions and problems• May provide health supervision to mid-level practitioners, staff nurses and other support staff• Assists in the resolution of complaints, requests and inquiries from patients• Maintains confidentiality of all patient information according to federal guidelines and regulations• Keeps and prepares accurate medical reports and records.

EDUCATION • Medical Doctor degree from an accredited school • Internal or Family Medicine specialty

CERTIFICATES, LICENSES AND/OR REGISTRATIONS• Medical degree in medicine with license to practice in Puerto Rico• Internist/ Family Care Physician; board certified preferred• Current DEA and DPS Certificate of Registration

EXPERIENICE• 3-5 years related experience and/or training or experience/education

REQUIREMENTS• Excellent communication and written skills in English and Spanish.• Ability to work as part of a multi-disciplinary team.• Ability to work well under pressure, analyze and evaluate individual member’s needs, reach sound conclusions and make appropriate recommendations• Must be detail oriented and be able to multi-task effectively.

TECHNICAL SKILLS• Microsoft Excel knowledgeable (Vlookup, tables, Pivot tables,etc.)• Statistical methods and packages (eg.g. SPSS) preferred• R and/or SAS languages preferred• Database design• Data mining• Data cleaning and munging• Data visualization and reporting techniques

LANGUAGE SKILLS Read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. Write reports, business correspondence, and procedure manuals. Effectively present information and respond to questions from groups of managers, clients, customers, and the general public.

MATHEMATICAL SKILLSWork with mathematical concepts such as probability and statistical inference, and fundamentals of plane and solid geometry and trigonometry. Apply concepts such as fractions, percentages, ratios, and proportions to practical situations.

REASONING ABILITYSolve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Interpret a variety of instructions furnished in written, oral, diagram, or schedule form.

ADDITIONAL SKILLS AND ABILITIES1. Able to assess health symptoms and provide accurate diagnoses.2. Must be able to prescribe the type of treatment that is appropriate to the condition as well as of the patient.3. Be able to skillfully apply techniques and principles of modern medical medicine.4. Effectively communicate with other medical staff and patients in both written and verbal forms.5. Must be able to establish effective and harmonious relations with medical staff, patients and the general public.6. Be able to coordinate day-to-day important medical efforts and activities with other medical and nurse staff.7. Must understand the requirements of indigent patients.8. Be able to interact effectively with clients from various social and economic backgrounds.9. Knowledge of and ability to apply professional medical principles, procedures, and techniques10. Thorough knowledge of pharmacological agents used in patient treatment11. Effective verbal and written communication skills along with proper telephone etiquette12. Performs in a tactful and professional manner13. Knowledge of healthcare industry – Health Plan, MSO, CMS, Federal regulations14. Must be team orientated15. Must be to function in a fast-paced environment with a positive and professional attitude16. Have the ability to prioritize and handle multiple projects and tasks with accuracy and attention to detail 17. Excellent verbal and written communication skills18. Proficiency with Microsoft Office Suite19. Knowledge of CMS regulations

PERFORMANCE MEASUREMENTS• Reporting functions are completed accurately and timely, and in accordance with established policies and federal and state regulations • Visitors and telephone calls are courteously and professional received. Good public relations exist with outside contacts• Department files are appropriately maintained and reported• Reports and analysis are up to date and completed in a timely mannerPhysical/Mental DemandsThis position requires regularly sitting and standing associated with a normal office environment. Perform tasks requiring independent knowledge and judgment in addition to instructions and procedures provided. Must be able to function with frequent interruptions, accept change and able to prioritize activities when faced with competing demands. Good Disposition to handle stress; work for long periods of time and/or over time when required by the administration.

Environmental/Working ConditionsNormal busy office environment. Moderate noise (examples: business office with computers and printers, light traffic). In some special project travelling around assigned regions could be required. General exposure to weather conditions while traveling and traffic situations. Valid driver’s license required to employees assigned to special projects. Evening, holiday or weekend work, could be required as necessary.

This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve.

If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!

Innovacare, Inc. is the leading provider of healthcare management in North America. Through two it’s main ways, Medicare Advantage and the provider network, we are committed to healthcare, creating models that are sustainable, cost-effective, and fully integrated with the most advanced technologies. Innovacare, Inc. combines innovation and quality care to create progressive, value-based models, even for the neediest patient populations. Our leadership team, with its vast years of combined experience in managed care and care delivery, is made up of leading experts with proven experience to help healthcare organizations effectively meet and exceed the growing demands of our industry.

InnovaCare Health's foundation was laid by President and CEO Richard Shinto, M.D., in 1998, when he joined North American Medical Management (NAMM) in California. Over the next 10 years, the company continued to grow, acquiring MMM Healthcare in Puerto Rico. In December 2012, the management team successfully sold select NAMM properties and officially formed InnovaCare Health to operate the remaining subsidiaries, including MMM. MMM Holdings, is a conglomerate of companies that work on Puerto Rico's business strategies, both for Medicare Advantage beneficiaries, through Medicare y Mucho Más (MMM), and for the beneficiaries of the government health plan with MMM Multihealth. Through InHealth Management, it manages the in-hospital care of the beneficiaries, while the specialized clinics, MMM Vita Care, serve members with chronic conditions. On the other hand, MSO of Puerto Rico supports medical groups, providers and other entities in the health industry, while Castellana Physicians Services is a medical group dedicated exclusively to providing services for the elderly and disabled population in Puerto Rico.

At the same time, the main company manages Medicare and Much More, a Medicare Advantage population health plan with a presence in Miami-Dade, Broward and Palm Beach counties. With a Mobile Application that allows members to check the status of their pre-authorizations, access their provider directory and schedule their future medical visits, Medicare and Much More integrates technology as a tool to improve the member experience. Also, the plan will ensure the health of members, during and after natural disasters. Through the Florida MMM Line of Care, as a Part D sponsor, you will ensure that the member has adequate access to their covered Part D drugs.

Orlando Family Physicians, a group of clinics that provide comprehensive care services in the state of Florida, is another of the companies managed by Innovacare, Inc. With more than 20 years of service in the Central Florida community and more than 100,000 patients cared, Orlando Family Physicians offers the personalized treatment and care that the patient deserves. With a track record that proves excellent customer service, we are proud that the largest Hispanic medical group in Central Florida has joined us. Our constant growth is the best witness we have to tell that things are being done well, so it is our commitment to continue on this path.

Innovacare, Inc. es el proveedor líder de manejo de servicios de salud en Norteamérica. A través de dos principales vías, Medicare Advantage y la red de proveedores, estamos comprometidos al cuidado de la salud, creando modelos que son sostenibles, costo-efectivos y completamente integrado a las tecnologías más avanzadas. Innovacare, Inc. combina innovación y atención de calidad para crear modelos progresivos y basados en el valor, incluso para las poblaciones de pacientes de mayor necesidad. Nuestro equipo de liderazgo con sus vastos años de experiencia combinada, en atención administrada y prestación de atención, está formado por expertos preeminentes con la experiencia comprobada para ayudar a las organizaciones de atención médica a satisfacer y superar eficazmente las crecientes demandas de nuestra industria.

Las bases de InnovaCare Health fueron establecidas por el presidente y CEO Richard Shinto, M.D., en 1998, cuando se unió a North American Medical Management (NAMM) en California. Durante los próximos 10 años, la compañía continuó creciendo, adquiriendo MMM Healthcare en Puerto Rico. En diciembre de 2012, el equipo de gestión vendió con éxito propiedades selectas de NAMM y formó oficialmente InnovaCare Health para operar las filiales restantes, incluida MMM.

MMM Holdings, es un conglomerado de compañías que trabaja las estrategias de negocio de Puerto Rico, tanto para Medicare Advantage, a través de Medicare y Mucho Más (MMM), como para los beneficiarios del plan de salud del Gobierno con MMM Multihealth. A través de InHealth Management maneja el cuidado intrahospitalario de los beneficiarios, mientras que, las clínicas especializadas, MMM Vita Care, atienden afiliados con condiciones crónicas. Por otro lado, MSO of Puerto Rico apoya grupos médicos, proveedores y otras entidades en la industria de la salud, mientras Castellana Physicians Services es un grupo médico dedicado exclusivamente a proveer servicios para la población de edad avanzada y discapacitada en Puerto Rico.

A su vez, la compañía matriz maneja Medicare and Much More, plan de salud para la población Medicare Advantage con presencia en los condados de Miami-Dade, Broward y Palm Beach. Con una Aplicación Móvil que permite a los afiliados verificar estatus de sus pre-autorizaciones, acceder su directorio de proveedores y agendar sus futuras visitas médicas, Medicare and Much More integra la tecnología como una herramienta para mejorar la experiencia del afiliado. También, el plan velará por la salud de los afiliados durante y después de desastres naturales. Por eso, a través de la línea de cuidado MMM de Florida, como patrocinador de la Parte D, se asegurará de que el afiliado tenga acceso adecuado a sus medicamentos cubiertos de la Parte D.

Orlando Family Physicians, grupo de clínicas que brindan servicios para el cuidado integral en el estado de la Florida, es otra de las compañías manejadas por Innovacare, Inc. Con más de 20 años de servicio en la comunidad de Florida Central y más de 100.000 pacientes atendidos, Orlando Family Physicians ofrece el tratamiento personalizado y la atención que el paciente merece. Con una trayectoria que prueba un excelente servicio al cliente, estamos orgullosos de que el grupo médico hispano más grande en Florida Central se haya unido a nosotros. Nuestro constante crecimiento es el mejor testigo de que las cosas se están haciendo bien por lo que es nuestro compromiso continuar por ese camino.