New Medicaid/Medicare Health Plan in state of AZ is seeking a Chief Medical Officer who will be responsible for contributing to and achieving overall company goals for company growth and financial performance. This is an opportunity to be part of the ground up build of a Medicaid health plan and help secure new business opportunities.
The Chief Medical Officer - CMO - will be responsible for strategic oversight of comprehensive medical policies including development, implementation, and evaluation of medical policies and programs targeting cost of care and clinical quality improvement.
Responsibilities will include:
- Management of physicians who manage relationships with state government agencies, provider network organizations and other physical and behavioral health entities to facilitate the delivery of appropriate quality of care.
- Oversee the clinical quality program, utilization management, care management, and disease management processes and outcomes
- Work closely with plan leadership and corporate clinical executive team to implement national medical and clinical policy and programs at a local level.
- Interface with national and state leadership and clients/stakeholders within region as needed to improve metrics and strategic plans
- Participate in the RFP process for new business opportunities and provide overall clinical direction for RFP responses
- Board Certified primary care, internal medicine or family medicine MD or DO with unrestricted AZ medical license.
- Managed care experience required
- Utilization Review and Care Management experience required.
- Clinical program development and strategic planning experience preferred.
- Experience doing medical necessity reviews, rounds and clinical coaching preferred.