Chief Medical Officer - Value Based Care

VCU Health • Richmond, VA

1d • Onsite

About The Position

The Chief Medical Officer (CMO) of VCU Health System Value-Based Care (VBC) serves as the clinical executive responsible for leading VCU Health’s Employee Health Plan, CIN, Direct to Employer, and other Value-Based Care initiatives. This leader will be primarily responsible for designing, leading, and optimizing the clinical care model and care teams supporting Direct-to-Employer customers, including oversight of the Center for Team Care—a comprehensive primary care and population health program for VCU Health employees that serves as a foundation for future direct-to-employer partnerships. This leader will build the Value-Based Care entity’s innovative care model, population health, and utilization management programs in such a way as to best serve VCU Health’s employees, its CIN at-risk population, and future employer-customers’ populations to achieve the Quadruple Aim of Better Care, Better Affordability, Better Patient Experience, and Better Provider Satisfaction. This leader will also serve as an internal and market-facing champion and thought leader for VCU Health’s Value-Based Care and Health Care Services Initiatives. The incumbent will creatively design care and population health programs, lead diverse internal care teams, and consult with benefits leaders and executives – both within VCU Health and with external employers - on benefit design, clinical model design, and the best strategies to achieve maximum value for employee benefits and health care spend. The CMO will maintain relationships with clinical and non-clinical executive leaders, current and prospective customers, and across the community to grow the VCU Health brand and expand business opportunities for VCU Health’s Value-Based entity and business lines.

Requirements

• Medical degree (MD, DO, or equivalent) with board certification in a medical or surgical specialty
• Current license to practice medicine in the Commonwealth or Virginia (MD or DO)
• 10 years of progressive leadership experience in an academic health system or large integrated healthcare organization
• Demonstrated leadership success in value-based care, population health, and/or risk-bearing organizations.
• Demonstrated success in clinical operations, quality improvement, patient safety initiatives, and healthcare economics.
• Experience partnering with employer customers and/or other healthcare purchasers on benefit design opportunities that facilitate improved value of benefits and optimal cost trends.
• Strong record of collaboration with health plan, health system and/or academic leaders.
• Exceptional communication, strategic thinking, and change management skills.
• Strong business skills, including executive presentation skills and healthcare financial acumen.
• Academic and/or large group practice prior experience as a practicing clinician.
• Working knowledge of population health strategies and demonstrated success designing and leading these programs.
• Experience in analyzing and improving population health program ROI.
• Demonstrated success in designing and executing initiatives that reduce medical cost trend in commercial employer, self-funded, and/or fully insured health plan populations.
• Expertise in fund flow design and execution in large health systems and between risk-bearing and clinical organizations.
• Prior experience leading teams to improve processes.
• Familiarity with performance improvement processes and change management concepts.
• Experience in implementing clinical guidelines and leading change with practicing physicians.
• Leadership in ACOs, clinically integrated networks, Medicare Advantage, or capitated commercial models.
• Experience with data analytics platforms, risk stratification tools, and performance dashboards.
• Excellent communication skills with the ability to interface with all levels and departments effectively on a formal, informal, written, and verbal basis.

Nice To Haves

• Clinical leadership training.
• MHA, MPH, MSHA, MBA, or a related graduate degree.
• Senior Executive experience in both a health plan and a health system.
• Academic medical center experience.
• Strong metrics and analytics experience.
• Experience building an organization/team from the start-up phase.
• Experience selling health benefits or being an accountable executive with a direct relationship with specific employer health benefit customers.
• Experience managing value-based initiatives, including population health programs in governmental payer business lines (i.e., Medicare and Medicaid).

Responsibilities

• Develop and execute the clinical strategy for VCUHS’ value-based care model, ensuring the delivery of high-quality, patient-centered care, utilization management, total cost-of-care initiatives, and governance.
• Sets the clinical vision, develops and implements new population health programs, aligns clinical operations with organizational goals, and develops a strategy for the continued growth of the Direct to Employer and CIN service lines.
• Uses data to identify high-risk populations and design targeted interventions.
• Develop and lead the strategy for risk prediction to optimally identify patients for proactive outreach within Direct-to-Employer and CIN populations.
• Leads clinical transformation initiatives for the Value-Based Population to improve patient safety, clinical effectiveness, and regulatory compliance.
• Coordinates with the Chief Quality and Safety Officer to establish metrics and accountability structures for continuous improvement across all value-based contracts and key performance metrics.
• Partners with Senior Leadership, CIN Boards, and CIN community practices to optimize clinical workflows, resource utilization, financial stewardship, and the benefit appeals process.
• Collaborates with Finance and Managed Care contracting teams to evaluate and manage clinical risk in shared savings, capitation, and downside risk arrangements, and optimizes current pay-for-performance contract terms.
• Identify, develop, and lead initiatives to reduce medical and pharmacy cost trends and increase the value of benefits in Direct-to-Employer and CIN populations.
• Consult with Direct to Employer customers on benefit design enhancements to improve the value of benefits, the health of employee populations, and medical cost trends.
• Partner closely with their PBMs and TPAs to develop the highest value benefit plans.
• Builds strong relationships with Nursing, Allied Health, and Administrative Leadership to promote integrated patient care delivery.
• Champion the adoption of new technologies and evidence-based practices to enhance patient outcomes and system efficiency.
• Partners with CMIO and IT to optimize EHR workflows, data integration, and clinical decision support tools in support of the IT roadmap for value-based care.
• Ensures compliance with accreditation standards (e.g., Joint Commission), federal and state regulations (e.g., HIPAA, CMS), and professional guidelines.
• Recruit, develop, and retain a high-performing value-based care clinical team.
• Performs other duties as assigned and/or participates in special projects to support the mission of VCUHS and the team.
• Accepting alternative responsibilities as required.

Benefits

• Periods of high stress and fluctuating workloads may occur.
• General office environment.
• Required to car travel to off-site locations, occasionally in adverse weather conditions.

What This Job Offers

• Job Type: Full-time
• Career Level: Executive
• Education Level: Ph.D. or professional degree