Chief Medical Officer

Overview The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. The Health Plan of San Joaquin is now hiring an experienced, mission-driven leader to serve as our Chief Medical Officer! Location: This is a remote position. Must reside in California, preferably within our service area to effectively support operational needs. Must be able to attend monthly onsite meetings, and other meetings as needed for business and community purposes. What You Will Be Doing As our Chief Medical Officer, under administrative direction, you will be responsible for leading efforts that will provide innovative solutions that support more affordable healthcare, promote personal accountability for health and wellness, and offer superior service and partnerships to the constituents served by HPSJ. Responsibilities Supervises: Medical Directors; Director of Pharmacy; Director of Clinical Analytics; Executive Assistant. Represents HPSJ in a manner that promotes a positive image; serves on internal and external committees and other leadership forums. Co-Chairs the Quality Improvement and Health Equity Transformation Committee and Chairs the Peer Review and Credentialing committee; serve on other committees as required. Ensures that direct reports promote and maintain an environment that supports HPSJ's strategy, vision, mission and values. Our Vision Continuously improve the health of our community. Our Mission We provide healthcare value and advance wellness through community partnerships. Essential Functions Identifies, develops, plans and executes short, medium and long-range strategies that drive and support corporate objectives; ensures the development and implementation of associated business plans, tactics and policies. Develops and oversees the implementation of medical management policies. Ensures that medical decisions are rendered by qualified medical personnel and are not influenced by fiscal or administrative management considerations. In collaboration with the Chief Health Services Officer, ensures consistent application of medical criteria to utilization management decision making. Collaborates with the Chief Health Services Officer in the strategic planning, implementation and oversight of the Quality Improvement and Quality Management Programs. Ensures that medical care provided meets acceptable medical care standards. Ensures that medical protocols and rules of conduct for HPSJ medical personnel are followed. Manages medical utilization through application of recognized medical and pharmaceutical guidelines and in collaboration with internal and external stakeholders. Oversees the development and management of department budgets. Oversees accreditation and compliance activities to ensure agreed upon and mandated standards are met. Identifies medical delivery system quality issues; develops and oversees implementation of corrective action plans in collaboration with the Chief Health Services Officer. Collaborates with network providers and the provider community in a manner that engenders positive relationships, provider support and network stability. Advises on complex, controversial and/or unique claims that are outside the realm of medical policy. Oversees quality and governance activities related to medical programs and committees. Ensures effective collaborative work and problem-solving routines between assigned departments and other stakeholders. Oversees the identification, preparation and maintenance of data, records and reports. Represents HPSJ in the community and in leadership forums. Promotes and maintains an environment that supports HPSJ's strategy, vision, mission and values; supports staff development and retention. Hires, develops and retains a competent staff and oversees staff performance. What You Bring Knowledge, Skills, Abilities and Competencies Required Expert knowledge of the principles, practices and techniques of managed care, utilization management and quality. Knowledge of laws and regulations governing managed care. Expert knowledge of contemporary health issues affecting Medi-Cal and/or Medicare populations, providers and the underserved in San Joaquin and surrounding areas. Knowledge of quality improvement and utilization management procedures and techniques. Knowledge of management and best practices techniques of a medical practice or office. Strategic mindset; ability to translate future possibilities into breakthrough strategies and to meet changing organizational and community needs, and regulatory requirements. Cultivates innovation; drives results and engagement; communicates effectively. Strong interpersonal, collaboration and relationship-building skills. Ability to speak and be understood in English; ability to handle confidential information with discretion. Strong budget development and management skills; project management and change management capabilities. Ability to supervise staff in a manner that maximizes performance and business results. Preferred Familiarity with seniors and Persons with Disabilities and Dual Eligible preferred. Familiarity with information technology, electronic medical records and other technological applications. Knowledge of NCQA accreditation, HEDIS and regulatory affairs. What You Have Education and Experience Required MD degree from an accredited medical school. Completion of an ACGME-accredited residency program; and At least ten years of clinical experience in medicine in a managed care setting; and At least five years of clinical experience with Medi-Cal and/or Medicare populations; or an equivalent combination of education and experience. Licenses, Certifications Unrestricted, active medical license in California; board certification in a medical specialty; and Satisfactory completion of an ACGME-accredited residency program; and Valid California driver license or ability to obtain transportation as required by counties served. HPSJ Perks What You Will Get Competitive salary Comprehensive health/dental/vision benefits with provider choices Generous PTO and paid holidays CalPERS retirement pension program with employer-paid contributions Two flexible spending accounts (FSAs) Employer-Paid Term Life, AD&D and Disability Insurance Life Assistance Program and Health Advocacy Supplemental legal, identity theft protection Exclusive discount opportunities Education and training reimbursement Mission-driven organization with community impact Opportunity for a shorter commute from the Central Valley to the Bay Area Physical Demands Frequent sitting, standing and walking; occasional handling of materials up to 50 lbs; closeup and distance vision requirements; occasional travel. Equal Opportunity We are an equal opportunity employer and diversity is a core value. Employment decisions are based on qualifications and merit. We prohibit discrimination based on race, color, gender, sexual orientation, age, national origin, disability, and other protected characteristics, per applicable laws. Important Notice This job description is not a contract between HPSJ and the employee. Duties may change at the discretion of HPSJ, and employees may be asked to perform duties not listed herein. #J-18808-Ljbffr

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