Job Information
Job Order ID :
WI3787674
# of Positions :
1
Minimum Education Level :
Master's Degree
Experience Required :
Training :
PhD
Salary :
$150000 + yearly
Duration :
Shift :
Unspecified
Hours per week:
40
Job Description
JOB REQUIREMENTS: Job Summary: The Vice President, Market Chief Medical
Officer has accountability for ensuring that local health plan,
CareSource initiatives focusing on clinical excellence, quality
improvement, appropriate inpatient and outpatient utilization,
affordability, health system transformation including provider network,
compliance with regulatory mandates, growth and other focused
improvements are implemented and successfully managed to achieve goals.
Essential Functions: Primary responsibility and accountability for Total
Medical PMPM performance and targets for the health plan, achieved by
close collaboration with relevant enterprise stakeholders Participate in
hospital Joint Operations Committee meetings with prioritized providers,
data sharing with physicians and physician groups on quality and
efficiency improvement opportunities, completing peer to peer
communications for quality of care as required, and implementing local
and national Health Care Affordability Initiatives in order to achieve
inpatient and outpatient utilization and affordability goals Provides
oversight to the HEDIS and CMS Stars data collection process and local
performance strategy, CAHPS improvement strategy, and drives Health Plan
accreditation activities as well as quality rating improvement
initiatives and other clinical interventions for the local health plan
Responsible for achievement of goals for contractually required clinical
Quality Performance Indicators and state regulator-driven
pay-for-quality initiatives. Oversees market peer review processes
including Quality of Care and Quality of Service issues, and leads the
Physician Advisory Committee (PAC), Quality Management Committee (QMC)
and other associated committees. Effectively engage with external
constituents such as consumers/members, physicians, medical and
specialty societies, hospitals and hospital associations, federal/state
regulators, and market-based collaboratives; act as the outward face to
State regulators based upon Contract, and direction of Plan President
and CareSource CMO and should provide clinical thought leadership with
external entities and the state Lead the development of a strategy to
identify clinical areas where there are disparities in health outcomes
across groups, and approach to closing gaps in health outcomes; support
the team in maintaining NCQA Multi-Cultural Distinction designation
Drive quality improvement and provider incentive models through
identification of appropriate practices; initial contact and target
setting, and Implementation, as well as ongoing leadership during\...
For full info follow application link. CareSource is an equal
opportunity employer and gives consideration for employment to qualified
applicants without regard to race, color, religion, sex, age, national
origin, disability, sexual orientation, gender identity, genetic
information, protected veteran status or any other characteristic
protected by applicable federal, state or local law. \*\*\*\*\*
APPLICATION INSTRUCTIONS: Apply Online: ipc.us/t/9B32D56B54374CCA
Company Information
Name :
CARESOURCE MANAGEMENT SERVICES LLC
Application Information