Market Chief Medical Officer

Amerihealth Caritas Health Plan•Southfield, MI

52d

About The Position

Your career starts now. We're looking for the next generation of health care leaders. At AmeriHealth Caritas, we're passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we'd like to hear from you. Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com. Role Overview: The Chief Medical Officer (CMO) serves as the senior clinical executive for the market, reporting directly to the Market President. This role leads the clinical strategy, population health initiatives, and quality improvement efforts to drive better health outcomes and cost-effective care delivery. The CMO collaborates with internal teams, providers, community stakeholders, and regulatory agencies to promote clinical excellence and operational efficiency.

Requirements

Minimum of five (5) years of active clinical practice in a medical specialty such as Obgyn, Pediatrics, Internal Medicine, Family Practice, or a surgical discipline.
At least five (5) years of progressive leadership in medical management is required. Prior experience as a Medical Director or Chief Medical Officer within a managed care organization is preferred.
Proven ability to lead clinical, quality, and operational teams in direct and matrixed environments.
Experience working across multiple lines of business, including Medicaid, Medicare, and ACA/Exchange.
Experience with quality improvement methodologies (e.g., IHI, Lean, Six Sigma).
Must hold a current unrestricted license to practice medicine.
Valid driver's license and car insurance.
Demonstrated knowledge of the health needs of diverse, low-income populations.
Strong decision-making skills with the ability to develop and execute strategic initiatives.
Advanced analytical capabilities with a focus on population health and cost-of-care outcomes.
Excellent verbal and written communication skills, with the ability to clearly convey complex clinical and operational concepts.
Ability to build effective relationships across all levels of the organization, including providers, regulatory agencies, and internal stakeholders.
Skilled in leveraging technology and data analytics to support clinical and operational performance.

Nice To Haves

Prior experience as a Medical Director or Chief Medical Officer within a managed care organization is preferred.

Responsibilities

Lead strategic direction and oversight of clinical programs, including care management, utilization management, and value-based care.
Play leadership role in the development and execution of provider engagement model to drive improved quality outcomes and increase provider satisfaction
Ensure financial performance, playing key leadership role to manage total cost of care (identification of opportunities through data analysis, development/execution of interventions, measurement of success)
Play key role in development and execution of member outcome improvement strategies.
Support strong strategic relationship with state Medicaid agency; developing and maintaining key relationships with state officials