- Primary responsibility and accountability for Total Medical PMPM performance and targets for the health plan, achieved by close collaboration with relevant enterprise stakeholders
- Participate in hospital Joint Operations Committee meetings with prioritized providers, data sharing with physicians and physician groups on quality and efficiency improvement opportunities, completing peer to peer communications for quality of care as required, and implementing local and national Health Care Affordability Initiatives in order to achieve inpatient and outpatient utilization and affordability goals
- Provides oversight to the HEDIS and CMS Stars data collection process and local performance strategy, CAHPS improvement strategy, and drives Health Plan accreditation activities as well as quality rating improvement initiatives and other clinical interventions for the local health plan
- Responsible for achievement of goals for contractually required clinical Quality Performance Indicators and state regulator-driven pay-for-quality initiatives.
- Oversees market peer review processes including Quality of Care and Quality of Service issues, and leads the Physician Advisory Committee (PAC), Quality Management Committee (QMC) and other associated committees.
- Effectively engage with external constituents such as consumers/members, physicians, medical and specialty societies, hospitals and hospital associations, federal/state regulators, and market-based collaboratives; act as the outward face to State regulators based upon Contract, and direction of Plan President and CareSource CMO and should provide clinical thought leadership with external entities and the state
- Lead the development of a strategy to identify clinical areas where there are disparities in health outcomes across groups, and approach to closing gaps in health outcomes; support the team in maintaining NCQA Multi-Cultural Distinction designation
- Drive quality improvement and provider incentive models through identification of appropriate practices; initial contact and target setting, and Implementation, as well as ongoing leadership during monthly JOCs. The Plan CMO is accountable for oversight of the entire clinical model (end to end) within the market, including, but not limited to, CareSource's Accountable Care Platform, clinical practice transformation, patient-centered medical homes, accountable care organizations, creative care management programs, high-performance networks and network optimization, and consumer engagement.
- Deliver the clinical value proposition focused on quality, affordability and service, in support of growth activities of the local Health Plan; actively promote positive relations with State/local regulatory authorities and Medical Societies
- Responsible for identifying opportunities through participation in enterprise and local Market reviews, and healthcare economics analyses; actively participate in various Joint Operating Committees and work collaboratively with Enterprise Clinical Services, Appeals and Grievances, pharmacy or shared services teams
- Lead and influence Health Plan employees by fostering teamwork and collaboration, driving employee engagement and leveraging diversity and inclusion
- Develop and mentor others while also building awareness to your own strengths and development need; identify and invest in high-potential colleagues; actively manage underperformance
- Focus staff on the company's mission; inspire superior performance; ensure understanding of strategic context; set clear performance goals; focus energy on serving the customer; provide ongoing communication to the team; discontinue non-critical efforts
- Communicate expectations and present effectively, listen actively and attentively to others, and convey genuine interest
- Perform any other job duties as requested
- Completion of an accredited Medical Degree program as a medical doctor (MD) or Doctor of Osteopathic (DO) medicine is required
- Successful completion of a residency training program, preferably in primary care is required
- A minimum of five (5) years of clinical practice experience with strong knowledge of managed care industry and the Medicaid line of business is required
- A minimum of two (2) years of Quality management experience is required
- Familiarity with current medical issues and practices
- Proven ability to execute and drive improvements against stated goals
- Strong leadership skills, as demonstrated by continuously improved results, team building, and effectiveness in a highly matrixed organization
- Excellent interpersonal communication skills
- Superior presentation skills for both clinical and non-clinical audiences
- Proven ability to develop relationships with network and community physicians and other providers
- Excellent project management skills
- Solid data analysis and interpretation skills; ability to focus on key metrics
- Strong team player and team building skills
- Strategic thinking with proven ability to communicate a vision and drive results
- Solid negotiation and conflict management skills
- Creative problem-solving skills.
- Proficiency with Microsoft Office applications
- Current, unrestricted license to practice medicine in state of practice as necessary to meet regulatory requirements is required
- Board Certification, preferably in primary care specialty is required; re-certification, as required by specialty board, must be maintained
- To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 – March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified.
- CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process.
- General office environment; may be required to sit or stand for extended periods of time
- May be required to work evenings/weekends
- Ability to travel as required by the needs of the business
- Create an Inclusive Environment
- Cultivate Partnerships
- Develop Self and Others
- Drive Execution
- Energize and Inspire the Organization
- Influence Others
- Pursue Personal Excellence
- Understand the Business
-
Medical Officer
2 weeks ago
FEFA, LLC Maryland, United StatesFEFA LLC is seeking an experienced Medical Officer with expertise in infectious diseases to join our team. The ideal candidate will have a medical degree from an accredited university, at least eight years of experience in medicine or a related field, and demonstrated expertise i ...
-
Medical Officer
15 hours ago
U.S. Army 1st Medical Recruiting Battalion Maryland, United StatesAdvance your career in one of the worlds largest and most advanced health care organizations. When you serve your country as a pulmonary disease specialist and officer, youll have the opportunity to be part of a ready-made practice, with no worries about overhead costs and malpra ...
-
Medical Officer of Health
15 hours ago
U.S. Army 1st Medical Recruiting Battalion Maryland, United StatesEnhance your medical career while helping to improve the health of our Soldiers. As a preventive medicine officer on the U.Army Reserve health care team, your duties will include creating, implementing and overseeing programs that improve physical fitness, prevent disease and red ...
-
Medical Officer GP
2 weeks ago
First Medical associates Maryland, United States Full timeJob Description Join Our Team: Primary Care Physician at First Medical Associates · Are you a dedicated primary care physician seeking a rewarding career in a tech-forward, multi-location Primary Care Group? First Medical Associates is a thriving healthcare provider that priorit ...
-
Hospital Medical Officers
15 hours ago
Physician Empire Maryland, United StatesPulmonary CC opportunity in MD: · Qualified BE / BC · Visa accepted: Yes (J1 and H1) · Practice type: Hospital Employed · Setting: provide ambulatory pulmonary clinic coverage. · Call: 1:8 · Join a group of 7 physicians · Great working environment · Level III Trauma · Bene ...
-
Hospital Medical Officers
15 hours ago
Physician Empire Maryland, United States30 minutes from the Beach · 2 hours from Baltimore, Washington DC and Philadelphia · Hospital is seeking 4 BE/BC OB/GYNs for a unique opportunity to create an employed practice within a physician lead professionally managed multispecialty medical group. · Practice OB/GYN on th ...
-
Director of Medical Staff Office
3 days ago
Washington Metropolitan Area Transit Authority Maryland, United States Full timeMarketing Statement: · Under Metro's Department of Safety, the ideal candidate for the Director of Response and Recovery Coordination in the Office of Emergency Preparedness that leads a 24/7/365 team of specialists, will need emergency management experience in operational respo ...
-
CareSource Maryland, United StatesVP, Market Chief Medical Officer(Need To Live In Florida) page is loaded VP, Market Chief Medical Officer(Need To Live In Florida) · Apply locations Florida WFH posted on Posted 2 Days Ago job requisition id R7147 Job Summary: · The Vice President, Market Chief Medical Officer h ...
-
Medcv Maryland, United StatesOverview · Internal Medicine/Pediatrics at Maryland Ocean in New Office Building Complex - hospital employed. This opening has it all: Flexible Office hours/schedule; Residency Stipend; School Loan Repayment; Loan Forgiveness; Signing Bonus; Relocation Expenses; Retirement Matc ...
-
Regional Sales Representative
3 days ago
Global Partners Maryland, United StatesJob Description: · We are hiring for a Regional Sales Representative, who will be a critical part of the Bids group, reporting to the Sales Manager - Commercial Accounts. You will be tasked to grow volume and margin through the sale of gas and distillate fuels. To succeed, you ne ...
-
Hematopathologist
1 week ago
Mid-Atlantic Permanente Medical Group Maryland, United States Full timeThe Mid-Atlantic Permanente Medical Group (MAPMG) proudly provides the highest quality integrated care for over 750,000 members in Virginia, Maryland, and the District of Columbia. We invite applications for a fellowship trained Hematopathologist for our Regional Pathology Lab l ...
-
Gastroenterologist
1 week ago
University of Pittsburgh Medical Center Maryland, United StatesHighlights: · * New 275 bed hospital with office on campus · * Over 300 medical providers, 2300 employees · * Employed Position · * Excellent subspecialty support · * Great schools, strong community and physician marketing support · * Outdoor recreation including golfing, biking, ...
-
Gastroenterologist
1 week ago
University of Pittsburgh Medical Center Maryland, United StatesUPMC Western Maryland Employed Gastroenterologist Opportunity · Opportunity Highlights: · * 5 GI Procedures,8 pre op and post op beds · * Excellent nursing support, state-of-the-art equipment. · * New 275 bed hospital with office on campus · * Over 300 medical providers, 2300 emp ...
-
AE Strategies Maryland, United StatesThe Clinical Trial Reviewer is a full-time physician position with the FDA. It is a hybrid role where candidates must live within commutable distance of the FDA Headquarters in Silver Spring, MD and willing to report to the office at least one day per week. The team follows tradi ...
-
Care Manager Social Worker
2 days ago
Peak Partners Maryland, United StatesPeak Partners has a client who provides caregiver support services, and they are in search of a Care Manager SW. This individual will have the responsibility for managing the clinical and medical care for clients to include vulnerable adults and elderly populations. · Responsibil ...
-
Dermatologist (PRN) in Halethorpe, MD
1 week ago
Mid-Atlantic Permanente Medical Group Maryland, United States Full timeThe Mid-Atlantic Permanente Medical Group, PC (MAPMG), located throughout the metropolitan Baltimore and Washington, D.C. areas, is currently interviewing for an hourly Dermatologist to join our South Baltimore Medical center . Enjoy an integrated medical system and freedom fro ...
-
Partner/Of Counsel
2 weeks ago
OneBridge Search Maryland, United StatesProminent law firm with a national practice is expanding and seeking a senior attorney for a partner or of counsel role for their Baltimore, MD office with 7+ years of Medical Malpractice defense experience. Portables are not required. · Responsibilities: · • Manage assigned case ...
-
Dermatologist
1 week ago
Mid-Atlantic Permanente Medical Group Maryland, United States Full timeThe Mid-Atlantic Permanente Medical Group, PC (MAPMG), located throughout the metropolitan Baltimore and Washington, D.C. areas, is currently interviewing for a Dermatologist to support out Lutherville Timonium Medical center . Enjoy an integrated medical system and freedom fr ...
-
Gastroenterologist (PRN)
1 week ago
Mid-Atlantic Permanente Medical Group Maryland, United States Full timeThe Mid-Atlantic Permanente Medical Group, PC (MAPMG) is currently seeking a General Gastroenterologist for a part-time hourly position supporting our Largo Medical Center , where the physician will provide consultative services and perform endoscopy. · Enjoy access to state of ...
-
Mid-Atlantic Permanente Medical Group Maryland, United States Full timeThe Mid-Atlantic Permanente Medical Group, PC (MAPMG), located throughout the metropolitan Baltimore and Washington, D.C. areas, is currently interviewing for a Dermatologis t to join our Gaithersburg Medical Center . Enjoy an integrated medical system and freedom from runnin ...
VP, Market Chief Medical Officer(Need To Live In Florida) - Maryland, United States - CareSource
Description
VP, Market Chief Medical Officer(Need To Live In Florida) page is loaded
VP, Market Chief Medical Officer(Need To Live In Florida)
Apply locations Florida WFH posted on Posted 2 Days Ago job requisition id R7147Job Summary:
The Vice President, Market Chief Medical Officer has accountability for ensuring that local health plan, CareSource initiatives focusing on clinical excellence, quality improvement, appropriate inpatient and outpatient utilization, affordability, health system transformation including provider network, compliance with regulatory mandates, growth and other focused improvements are implemented and successfully managed to achieve goals.
Essential Functions:
Education and Experience:
Competencies, Knowledge and Skills:
Licensure and Certification:
Working Conditions:
Compensation range $150,000-$300,000 . CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type (hourly/salary):
SalaryOrganization Level Competencies
This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer, including disability and veteran status. We are committed to a diverse and inclusive work environment. Similar Jobs (3) VP, Market Operations(Need to Live in Florida)
locations Florida WFH posted on Posted 2 Days AgoHealth Partner Network Manager(Needs to live in Florida)
locations Florida WFH posted on Posted 2 Days AgoVP , Network Contracting & Strategy(Need to live in Florida)
locations Florida WFH posted on Posted 2 Days AgoThe CareSource mission is known as our heartbeat. Just as we support our members to be the best version of themselves, our employees are driven by our mission to create a better world for members, stakeholders and providers.
We are difference-makers who combine compassionate hearts with our unique business expertise to make every opportunity count. Each claim, each phone call, each consumer-centric decision is a chance to change the world for one member, and our employees look for ways to do that every day.
The challenge is, there is no one right way to be the difference and we're looking for people like you that will rewrite that definition every day. We do what it takes to form creative solutions that make our community and the world just a little better. Discover what it means to be #UniquelyCareSource.
#J-18808-Ljbffr