CMO - HealthHelp

WNS Global Services•Houston, TX

9h•$380,000 - $425,000

About The Position

Reporting to the Chief Executive Officer, the Chief Medical Officer (CMO) will have primary responsibility for ensuring clinical quality and program optimization across HealthHelp’s products and be an integral part of driving growth, supporting ongoing client engagement, physician partnerships, product innovation support and thought leadership initiatives. As a core member of the Senior Leadership Team, this role will have high visibility at the Corporate and Client levels while acting as a servant leader to their own teams. The CMO will oversee the organization’s clinical capabilities by ensuring it meets quality and accreditation standards by leveraging extensive experience with prior authorization processes, ecosystem connectivity, and creative problem solving. This role will be responsible for overall clinical integrity by bringing focused structure to quality and accreditation, clinical area outcomes to optimize product performance with rules and guidelines, and to client satisfaction by driving and testing the executed clinical model, ensuring all programs operate on industry standards and regulations. This role will require a clinical background, strong business acumen, data driven decision making, a high level of emotional intelligence, the ability to delegate effectively and treat others with respect.

Requirements

Current, active, unrestricted license to practice medicine in a state or territory of the United States
Medical degree, either an M.D. or a D.O., from an accredited school of medicine
Meets HH’s credentialing requirements
Strategic vision of the national and international healthcare delivery marketplace
Seven (7) years of experience in a specialty field or medical management in a health plan
Three (3) years of experience developing and maintaining administrative claims data sets for the purposes of outcomes analysis and outcomes management
Five (5) years of experience working in a team environment and three (3) years of experience in supervisory position(s) managing direct reports
Three (3) years of experience managing budgets
Working knowledge of statistics
Excellent communication skills with supervisors, peers, subordinates, and clients, and ease with public speaking
Time management
Complex problem solving
Fluency of ideas
Active listening
Critical thinking
Ability to manage personnel resources
Ability to manage financial resources
Oral and written comprehension
Inductive and deductive reasoning
Ability to develop and build teams
Ability to develop objectives and strategies
Good supervisory and delegation skills – always holding direct reports accountable for the timeliness and effectiveness of their work
Good leadership qualities

Nice To Haves

Board certified in one of HH’s specialties, preferred
Advanced degree in management, such as M.B.A., M.P.H., or M.H.A.

Responsibilities

Represents and serves as the clinical face of HealthHelp (HH) to health plan clients and providers, prospective clients, associations, Medical Directors, Consult Physicians, nurses, and the general public
Confers with board members, organization officials, and/or staff members to discuss issues, coordinate activities, and resolve problems impacting clinical operations
Responsible for oversight of all clinical operations entities, including medical director and physician reviewer staff
Oversees the HH Quality Management Program and directs its Quality Management Committee
Directs, plans, and implements policies, objectives, and activities for clinical programs to ensure their continuing improvement in operational efficiency and effectiveness
Oversees the quality of all clinical aspects and assures investors and executive management that all healthcare programs are being implemented and managed properly.
Carries out effective, collaborative communication with Program Management and all operations support entities in order to achieve optimal operational coordination of all clinical programs
Recommends changes to clinical review protocols and coordinates revisions to clinical criteria, as indicated, ensuring quality and safety for health plan client members and providers
Directs staff in the development of educational materials, as needed
Conducts educational programs and seminars, as appropriate
Responsible for the ongoing development and implementation of inter-rater reliability audit programs
Provides oversight for quality improvement projects, as needed