Job Summary Westmont Search is conducting a nationwide search for a Chief Medical Officer, Population Health. The Chief Medical Officer, Population Health (CMOPH) is an outstanding leadership opportunity for a results driven, operationally talented, innovative, collaborative leader to join a prestigious, clinically sophisticated, and mission-driven health system. Reporting directly to the Chief Medical Officer of the hospital system, the C hief Medical Officer, Population Health , will be responsible for serving as the clinical leader for population health and accountable care operations. The CMOPH is a member of the population health leadership team and works closely with Market Presidents, the system and market Chief Medical Officers, the Senior Director of Care Management, Vice-President of Population Finance and Analytics, Vice President of Payer Contracting, Director of Community Health and leadership of the clinical practices, information systems and management, finance, and pharmacy leaders. The CMOPH is responsible for providing clinical expertise and driving clinical practice changes in support of population health programs to promote the delivery of high quality and cost-effective care for the populations we are privileged to serve. In addition, the CMOPH will serve as the lead clinical liaison to external health plan partners, external providers, and applicable regulatory and credentialing organizations. Principal Duties and Responsibilities Strategy ??? Work collaboratively with the Chief Population Health Officer and other leaders of the leadership team to assist in developing short and long-term strategic goals for population health programs. This includes Medicare, Medicaid, MSHO and Commercial risk-based programs. ??? Identify, analyze, and lead the development of programs that target: - Improved member experience - Improved quality of care - Growth in membership - Effective utilization of resources - Reduce practice variation ??? Introduce strategic plans and initiatives to the clinical and operational leaders within and among the preferred provider network. ??? Collaborate with leadership and members of the Population Health leadership team in order to develop plans to expand population health programs across new and developing markets. Provider Engagement ??? Collaborate with physician leaders, employed physicians, community physicians, staff, and constituencies to support their efforts to improve utilization, quality of care while closing gaps in care, patients/member experience, medical documentation, and HCC coding, while lower the total costs of care etc. for the population health programs. ??? Collaborate with physician leaders, physicians, advanced practitioners, and other clinician to drive changes in clinical practice that support the quadruple aim of lower costs, high quality, patient engagement and provider. Uses tools such as ADKAR and other change management tools to effectively advance the clinical practice transformation while achieving results in value-based care. Such programs include remote patient monitoring and Hospital at Home. ??? Communicate, educate, and develop partnerships with payers and providers and serves, when needed, as the interface between the population health team and its constituencies. ??? Oversee the clinical and operational performance of performed network of skilled nursing facilities, hospice, and home care providers and post hospitalization which include discharge planning and its preferred network. ??? Provide direct supervision of the Assistant Medical directors and provides direct patient care plans for certain dual eligible programs. Medical Management ??? Execute predetermination reviews, reviews of claim determinations, providing clinical, coding, and reimbursement expertise. ??? Manage UM transactional work (front line reviews and appeals). ??? Oversee utilization review/quality assurance in collaboration with case management. ??? Partner with care management and medical management leadership to increase effectiveness of medical management programs and to promote the integration of other medical programs. ??? Provide clinical guidance in operating effective medical programs to promote member and patient quality of care and in reviewing potential lapses in the quality of care. ??? Oversee the performance and expansion of existing Chronic Care Management programs (i.e Chronic Heart Failure, Cancer, Diabetes, diabetes prevention etc.). ??? Designs and develops evidenced based best practices and care pathways in conjunction with clinical market leaders and section chairs. Other ??? Proactively use data analysis to identify opportunities for quality and clinical improvement, to positively influence the effective delivery of quality care. ??? Work collaboratively with other functional areas that interface with care management, medical management, and utilization review. Reporting Relationships The Chief Medical Officer, Population Health reports to the Chief Medical Officer Assistant Medical Directors in population health will report to this position. Candidate Qualifications Experience and Education Experience: Clinical Practice: 5-10 Years of direct patient care Administration/Management - 2-3 years of experience in Health Care Delivery System - 2-3 years of experience in Clinical leadership (ex. quality review, peer review, group/practice management, hospital teams) Medical Management or Care Management - 5+ years of knowledge/experience in managed care (consultant, medical director, discharge planning) Strong analytical and quantitative skills a must Ability to build consensus, provide strong leadership in a team environment, and have the highest sense of professional integrity. Highly proficient communication, customer service, and interpersonal skills are required to work successfully with various levels of leadership and management personnel, as well as the public and external community. Highly effective written and verbal communication and interpersonal skills are required to work successfully with various levels of administrative and management personnel. Meticulous attention to detail with an appreciation of complexity and risk. Education: Graduate of an accredited medical school; Doctorate degree in Medicine Candidates with post-graduate degrees (e.g., MBA, MPH, MMM) preferred. Certification/Licensure: Required ??? Board certification in an American Board of Medical Specialties (ABMS) recognized specialty ??? Active, unrestricted active or ability to obtain a appropriate Medical License as a Doctor of Medicine or a Doctor of Osteopathy
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