Hello, we’re Belong.
We partner with regional payers to deliver Medicare Advantage and Special Needs Plan products.
With a dual focus on data-driven, proactive clinical intervention and unwaveringly empathetic patient experience, Belong has completely reimagined health insurance for seniors and other Medicare-eligible individuals who have been disregarded and deprioritized for far too long.
We believe that only by recognizing individuals can we make communities strong.
Belong Health. Kinder, more supportive care.
Why do we exist?
Belong Health was created to bring a high-quality, seamless customer experience to vulnerable Americans with complex health needs. We believe that all Americans deserve an opportunity for optimal health, and we understand that health is related to many factors outside of traditional healthcare. We are dedicated to a vision of the future where holistic health incorporates data and technology into a humanistic and behaviorally sophisticated model of care.
What do we do?
Belong Health is a partner platform launch- built-for-purpose, technology-enabled healthcare organizations. They aggregate the leading talent in the market to solve specific problems in healthcare that improve the lives of patients and lead the industry towards a more rational, sustainable, and humane model of care. Belong Health partners with regional health plans to deliver best-in-class Medicare Advantage (MA) and Specials Needs Plan (SNP) products, creating new opportunities for organic growth that enable better service for their existing membership.
How do we do it?
Belong Health provides the services and funding to launch a new health plan: Belong Health works with regional health plans to understand their relative market position & operational strengths, create specific strategies that deliver MA / SNP membership, and launch complementary but distinct new plans together.
Reports to: Chief Clinical Officer
- Travel throughout Belong Health’s service area is required.
- Provides clinical expertise and timely first and second level clinical determinations based on Belong Health’s policies/procedures, state and federal guidelines, national accreditation standards, benefits interpretations, and other medical necessity criteria as necessary
- Leads Belong Health’s efforts to collaborate in person and virtually with network providers and facilities around clinical determinations, policy interpretation, sharing of leading indicators and quality data
- Partners with other leaders and executives to represent integrated health programming to state, federal and other regulators as needed
- Identifies and implements initiatives in collaboration with other senior leaders to promote appropriate clinical care quality, service utilization, medication utilization and adherence, care management, and cost control
- Through matrixed leadership, supports other key stakeholders such as sales and marketing, quality, operations, and others
- Supports and communicates effectively with Belong Health’s Quality Improvement, Pharmacy, Health Promotions, and Disease Management Programs
- Actively participates in all Belong Health training and medical directors’ meetings and conference calls
- Represent the organization in community and marketing events.
- Build strong relationship with specialist, hospitalist, SNF and other providers to form a narrow network of quality service focused on senior population health
- Represent the organization in community and marketing events.
- Provides coverage outside of normal business hours on a rotational
- In addition to their administrative duties, as a licensed Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO), the RMD will maintain an active clinical practice by providing direct patient care services to our members when necessary.
- Must be a New York State resident
- Other duties as assigned
Education, Training and Professional Experience:
- Licensed to practice medicine as a physician in the state of New York
- Board Certified in Internal Medicine, Family Medicine, Geriatric Medicine, or combined Internal Medicine-Pediatrics
- Graduate of accredited MD or DO program of accredited university
- Demonstrated success driving value-based care models
- Must have experience working in a high growth organization
- Minimum of 3 years post residency experience in a clinical or managed care setting is required, at least 2 years in a clinical setting
- Previous experience as a medical director in a managed care or health plan is desirable
- Knowledge of and experience with NCQA requirements and HEDIS reporting is highly preferred
- Proven track record leading physician groups, including group facilitation, leadership development, team-building, performance management, and driving cultural change
- Medical quality and performance improvement experience
- Utilization review experience
- Knowledge of Medicaid and Medicare programs
- Excellent oral and written communication skills
- Population health expertise
- Self-motivated, mission-driven, creative & resourceful
- Driven by passion and dedication to serve vulnerable and at-risk populations
- Determined to bring best-in-class value-based clinical care models to highly-complex populations with unmet medical, social & behavioral health needs
- Able to develop relationships with all employees – from executives to front-line-staff
- Demonstrates professional judgement and can operate as a trusted advisor
- Highly professional and maintains confidentiality
- Able to manage to a budget
- Experience with critical review in clinical scenarios is desirable
- Strong organizational, communication, and writing skills for function in a highly matrixed environment are essential
Belong Health: Health and Safety Policy
Belong Health and its partners will require full vaccination for associates and select contractors conduct work outside of their home on behalf of Belong Health and its partners. This applies to those who work within our facilities; interact directly with members and patients; attend in-person meetings or trainings; and/or represent Belong Health at events or volunteer activities. Medical and religious exemptions will be available, and this policy will not supersede state or local laws.
Belong Health is an equal opportunity employer and encourages all applicants from every background and life experience to apply.