201 Best eligibility specialist Jobs in Los Angeles, California (November 2025)

St Johns Community Health

Regional Medical Director

27 days ago

Los Angeles

Job Description This position leads, manages, and supervises Floater Providers in an assigned region and/or specialty care area(s), as well as promotes the integration of clinical programs including dental, vision, pharmacy, and case management, and any specialty services offered at St. John’s Community Health. As a medical provider, he/she will provide comprehensive, coordinated, primary and preventive health care services to a diverse & underserved patient population. In performing this work, the Regional Medical Director ensures execution of assuring access to high quality, affordable care for all. Ideally, this position would spend 50% of their time on administrative duties and 50% of their time on clinical duties. The Regional Medical Director actively participates in the various committees and Meetings where Medical Leadership input is necessary and provides direct supervision of the floater providers and other designated clinicians as appropriate. Benefits: • Free Medical, Dental & Vision, • 13 Paid Holidays + PTO, • 403 (B) retirement match, • Life Insurance, EAP, • Flexible Spending Account, • Continued workforce development & training, • Board Certified Physician, Nurse Practitioner or Physician Assistant., • California License to practice medicine and unrestricted DEA License., • Experience in a leadership and working with underserved patient populations with preference in community health centers., • Demonstrated experience developing and implementing quality improvement programs., • Experience with managed care, administration of programs, and staff supervision., • Demonstrated experience with Electronic Medical Records and Computer Based Systems. Recruitment and Onboarding • Supporting Regional Medical Directors with interviews of Advance Practice Providers and site visits as necessary., • Working in collaboration with Director of Recruitment, Human Resources, and Credentialing in enduring timely start of clinicians., • Ensures adequate initiative and participation from onboarding mentors for adequate training., • Supervision of Chart review and closures of floater providers, • Perform chart audits on providers as needed., • Report chart audit findings reported to CMO and RMDs after completion of each Chart Audit., • Take necessary action to rectify the audit findings based on guidance from the CMO or designee., • Propose a plan to ensure that the delinquencies are not repeated., • Working in Collaboration with Programs to provide clinical support in achieving grant deliverables and site visits for above mentioned programs under the direction of the Chief Medical Officer., • Working in collaboration with Programs to provide clinical support in analysis and management of date related to above mention programs under the direction of Director of Quality and Compliance., • Working in collaboration with Medical Leadership Team to provide clinical support in achieving audit deliverables and site visits for HRSA/MHLA, and other organizations under the direction of the Chief Medical Officer., • Supports and implements the organization’s vision, mission and values., • Conducts orientation for new medical staff members covering St. John’s philosophy, medical protocols and providing proper patient care., • Ability to organize and prioritize work without supervision. Expertise with various computer applications such as EHR, Microsoft Excel and Word., • Supervises personnel to include screening, interviewing, hiring, disciplining and terminating. Guides, directs, disciplines, coaches and motivates staff regarding work performance, problem solving, and decision making to ensure staff meet work standards. Conducts all aspects of supervision in a professional, consistent and objective manner., • Assists in the recruitment and selection of the site's lead providers and clinicians., • Participates in setting staffing levels and training initiatives in area(s) of responsibility., • Supervise all medical services offered by the programs., • Completes probationary and annual performance reviews on or before the due date(s)., • Handle clinical grievances and incident reports pertinent to the patient care on a local level. Involving HR/CMO and escalating to next level of management as appropriate., • Ensure that all programs are effectively accomplishing goals established and all activities are clearly documented., • Actively participates with other Regional Medical Directors and welcomes others to participate in his/her facility(ies) committees., • Meet with Lead providers and other providers as needed on quality issues at least monthly., • Conducts provider meetings on regular basis in collaboration with other Reginal Directors and Chief Medical Officer., • Working closely with other regional directors and CMO, reviews and approves all clinical policies and medical protocols and standing orders regularly. Assists in overseeing quality of patient care. Monitors clinical issues to ensure proper protocols are used and risk is minimized., • Performs job duties independently and exercise good judgment., • Where applicable, reviews credentials and delineates clinical privileges for the physicians, dentists, nurse practitioners and optometrists providing service within the organization., • Coordinates clinical care with Dental Director and cross refers dental patients., • Promotes clear lines of communication between Medical Operations and the other staff members in all area(s) of responsibility., • Disseminates and interprets outcomes information for the clinicians and uses that information to improve quality of care within the area(s) of responsibility that is consistent with national standards., • Represents SJWCFC with the administration and medical staff of contracted hospitals, building a cooperative, professional relationship. Assesses care provided to St. John’s patients by hospitalists and specialists. Participates in quality and utilization reviews of care provided to St. John’s inpatients., • Develops and implements the clinical staff education and training plan for technology adoption., • Identifies and utilizes learning opportunities to increase personal leadership/management skills and clinical and technical proficiency and knowledge., • Uses discretion and judgment in handling sensitive or confidential information. Answers all employee and client inquiries in a timely and courteous manner. Listens and responds to employee disputes. Understands which decisions can be made alone and which need to involve others., • Sets level of medical care and quality for patients and monitors care using available data and chart reviews., • Actively involves in Population health management including specialty care services., • Helps with EMR optimization, data governance, quality assessment and improvement. Monitors quality metrics for the assigned clinics and aims to constantly improve the measures at site level, regional level and company level., • Participates and takes lead in in other projects as required., • Help co-ordinate new provider orientation, on-boarding, including trainings for the internship program., • Reviews patient file/record, including allergies, problems, medications and immunization status., • Elicits and records information about patient’s medical history., • Examines patients for symptoms or physical information., • Orders or executes various tests, analyses and diagnostic images to provide information on patient’s condition., • Analyzes reports and findings of tests and examination and diagnoses condition of patient., • Administers or prescribes treatments., • Determines and prescribes medication, dosage and schedule given the patient’s condition and allergies., • Discusses any possible side effects to medication or immunization with patient., • Prescribes vaccinations to immunize patient from communicable diseases., • Promotes health by advising patients about diet, hygiene and methods for prevention of disease., • Provides prenatal care to pregnant women. Provides postnatal care to mothers and infants., • Performs surgical procedures commensurate with surgical competency., • Refers patients to medical specialist for consultant services when necessary for patient’s well-being., • Documents the patient’s visit including medical history, physical exam, diagnoses and plan of action., • Follows up with patient regarding progress in high risk or emergency cases., • conducts physical examinations to provide information needed for admission to school, consideration for jobs, or eligibility for insurance coverage., • Administer Family Planning services in compliance with title X Rules and Regulations/Protocols., • Reviews and audits health charts of patients who receive Family Planning services., • Attends annual Family Planning seminars, if instructed by the CMO., • Commitment to mission of St. John’s with clinic involvement and engaging in healthcare community events, • Provider goals: sees minimum of twenty-four patients per day subject to clinic goals, • Provide cross-coverage to fellow Clinicians during weekdays and weekends., • Educates patients and family members in health promotion, disease prevention and birth-control methods as appropriate., • Helps coordinate efficient flow of patients through the system of care., • Provide basic mental health assessment and treatment of non-emergent conditions such as anxiety, depression and simpler eating disorders., • Practices safety, environmental, and/or infection control methods., • Helps provide triage services and treatment services during disaster, per protocol., • Provide a proportionate share of daily supervision and be able to act as mentor to PA/NP and co-sign their charts., • Coordinate financial budget with CMO and CFO, • Monitors financial performance, sets goals (financial, quality, etc) for the provider team and monitor and hold them accountable., • Oversees the management of participant's medical situations and oversees the site's use of medical specialists and inpatient care. Focuses on the financial objectives of market/company., • Evaluates the capital equipment and staff needs of each area(s) of responsibility, making recommendations to the appropriate management personnel., • Participates in all area(s) of responsibility to bring new business to the centers., • Recommends potential growth opportunities for new or existing services within the market., • Engage with outreach and case management staff to inform and implement community engagement strategies., • Represent the Collaborative at relevant community and government meetings, including Right to Health Committee meetings, and other collaborative opportunities., • Engage with community, and government stakeholders to achieve work plan objectives

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