CMO
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Job Description
Chief Medical Officer overseeing clinical quality and driving program optimization at HealthHelp. Leading health plan client engagement and clinical operations management.
Responsibilities:
- Represents and serves as the clinical face of HealthHelp (HH) to health plan clients and providers, prospective clients, associations, Medical Directors, Consult Physicians, nurses, and the general public
- Confers with board members, organization officials, and/or staff members to discuss issues, coordinate activities, and resolve problems impacting clinical operations
- Responsible for oversight of all clinical operations entities, including medical director and physician reviewer staff
- Oversees the HH Quality Management Program and directs its Quality Management Committee
- Directs, plans, and implements policies, objectives, and activities for clinical programs to ensure their continuing improvement in operational efficiency and effectiveness
- Oversees the quality of all clinical aspects and assures investors and executive management that all healthcare programs are being implemented and managed properly.
- Carries out effective, collaborative communication with Program Management and all operations support entities in order to achieve optimal operational coordination of all clinical programs
- Recommends changes to clinical review protocols and coordinates revisions to clinical criteria, as indicated, ensuring quality and safety for health plan client members and providers
- Directs staff in the development of educational materials, as needed
- Conducts educational programs and seminars, as appropriate
- Responsible for the ongoing development and implementation of inter-rater reliability audit programs
- Provides oversight for quality improvement projects, as needed
Requirements:
- Current, active, unrestricted license to practice medicine in a state or territory of the United States
- Medical degree, either an M.D. or a D.O., from an accredited school of medicine
- Board certified in one of HH’s specialties, preferred
- Advanced degree in management, such as M.B.A., M.P.H., or M.H.A.
- Meets HH’s credentialing requirements
- Strategic vision of the national and international healthcare delivery marketplace
- Seven (7) years of experience in a specialty field or medical management in a health plan
- Three (3) years of experience developing and maintaining administrative claims data sets for the purposes of outcomes analysis and outcomes management
- Five (5) years of experience working in a team environment and three (3) years of experience in supervisory position(s) managing direct reports
- Three (3) years of experience managing budgets
- Working knowledge of statistics
- Excellent communication skills with supervisors, peers, subordinates, and clients, and ease with public speaking
- Time management
- Complex problem solving
- Fluency of ideas
- Active listening
- Critical thinking
- Ability to manage personnel resources
- Ability to manage financial resources
- Oral and written comprehension
- Inductive and deductive reasoning
- Ability to develop and build teams
- Ability to develop objectives and strategies
- Good supervisory and delegation skills – always holding direct reports accountable for the timeliness and effectiveness of their work
- Good leadership qualities
Benefits:
- Medical, dental, and vision insurance
- Paid time off (PTO), holidays, and sick leave
- 401(k) with company match or other retirement plan
- Life and AD&D Insurance
- Employee Assistance Program
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