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LPC Healthcare Recruiting Solutions Inc has a great opportunity for a Chief Medical Officer. The Chief Medical Officer (CMO) will represent the managed care company with Hospital Owners, Board of Directors, Community, Customers, Providers, and Members as part of the senior management team. The CMO will oversee the development of clinical strategies, including the development of, clinical programs, standards and policies designed to ensure the quality, outcomes and cost-effectiveness of medical care provided to Members and Customers. The CMO will provide leadership, clinical oversight and guidance to maintain the highest levels of service quality. This position will optimize utilization levels, and increase the efficacy, efficiency and effectiveness of health service delivery. The CMO will develop and maintain collaborative relationships with regulatory agencies such as DPW, DOH, NCQA, CMS, etc. to ensure that all clinical protocols and procedures meet and are consistent with regulatory requirements.
Training and Board Certification in a primary care specialty (e.g., family practice, pediatrics, or general internal medicine), active IL medical license; 5 years’ experience in a managed care and/or indemnity insurance with 3+ years management responsibility at a senior Medical Director level. Five years successful experience in developing and managing a staff of Medical Directors and the associated operating budget is highly preferred. Five years’ experience working as a part of cross-functional, self-directed teams is preferred. Graduate Degree in a related business management field (MBA/MPH) is desirable.
Excellent oral, written and verbal communication skills. Ability to balance service provision with cost containment. Knowledge of health care economics. Broad Medical Director experience encompassing utilization management, case and disease management, and quality. Demonstrated medical leadership, organizational and communications skills. Strong independent decision making ability. Experience in developing and analyzing care management programs that have demonstrated both clinical and financial improvements in a managed care setting. Strong influencing, negotiation and analytical skills. Strong personnel development, team-building and mentoring skills. Working Knowledge of PC based applications such as Excel, Powerpoint and Word. Direct budgetary and P+L accountability for operations. Demonstrated success in taking an MCO through CMS, State, and NCQA audits/site visits. Experience with developing care management programs
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