[Hiring] Chief Medical Officer @CVS Health

Role Description

The ABHMI CMO will serve as a strategic and operational partner to the Health Plan CEO, COO, CFO and other executive team members in Medicaid driving clinical excellence, achieving measurable health outcomes, and supporting quality and medical management in a highly matrixed environment. The CMO will also support national strategic processes and priorities as well as conceptualization, design, and implementation of strategic priorities for Medicaid. The State CMO will be responsible for cost containment outcomes and defined KPI’s and overall growth and success of the plan through effective clinical leadership.

• Accountable for overall plan results and the delivery of high-quality cost-effective products and services that strategically align to the goals of the State partner.
• Ensures members get the right health care treatment for their needs, working to eliminate low value care, over and underutilization of health care services in alignment with the Quintuple AIM.
• Participates with plan leaders in identification and developing the appropriate enterprise and local strategies to fulfill plan business goals and growth imperatives.
• Provide clinical expertise to shape the integrative model of physical, behavioral, and health related resource needs to support holistic care and optimal health outcomes.

Qualifications

• At least five years’ experience in the health care delivery system e.g., clinical practice and health care industry.
• At least three years of experience Medicaid and managed care experience.
• Must be a physician with a current, unencumbered license through the state of Michigan.
• Board Certification in a recognized specialty including post-graduate direct patient care experience.

Requirements

• Develop, implement, support, and promote population health strategies, tactics, policies, and programs that drive the delivery of high value healthcare to establish a sustainable competitive business advantage by supporting the plan goals.
• Review, interpret and analyze data and trends at State level in: UM, CM, Pop Health and Health Equity in order to identify risks and opportunities for improvement.
• Serve as clinical executive leader for State regulators, providers, and other key partners. Serve as clinical leader for provider engagement and enablement.
• Have oversight of the design, development, and deployment of Care Models and review medical care provided to Enrollees and medical aspects of the Provider Contract.
• Ensure clinical programs are compliant with all national and state regulations including ensuring compliance with State and local reporting laws on communicable diseases, Child Abuse, and neglect.
• Management of the Quality Assessment and Performance Improvement Program (QAPI).

Benefits

• Comprehensive and competitive mix of pay and benefits.
• Medical, dental, and vision coverage.
• Paid time off.
• Retirement savings options.
• Wellness programs and other resources, based on eligibility.

Company Description

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.