Market CMO

Humana • Daytona Beach, FL

257d • $270,800 - $378,800 • Onsite

About The Position

The Market CMO serves as a health-care professional and capable of handling a variety of health-related problems. The Regional Medical Director requires an in-depth understanding of how organization capabilities interrelate across the function or segment. As Market CMO over our Daytona area market you will plan, organize, manage, and supervise health care services offered in the medical centers. Work in conjunction with the Area Medical Directors to motivate and provide medical direction in pursuit of cost effective, quality healthcare. At Conviva Physician Group, we want to help those in the communities we serve, including our associates, lead their best lives. We support our associates in being happier, healthier, and more productive in their professional and personal lives. We promote lifelong well-being by giving our associates fresh perspective, new insights, and exciting opportunities to grow their careers. Our culture is focused on teamwork and providing a positive and welcoming environment for all.

Requirements

• Graduate of accredited MD or DO program of accredited university.
• Master's Degree.
• Licensure requirements of the state of jurisdiction.
• Prefer Internal Medicine specialty.
• Board Certification in Family Medicine, Internal Medicine, or Geriatric Medicine.
• 8 or more years of technical experience.
• 5 or more years of management experience.

Nice To Haves

• Knowledge of Medicaid and Medicare programs.
• Excellent oral and written communication skills.
• Good understanding of best practice coding and documentation in value-based environment.

Responsibilities

• Plan, organize, manage, and supervise the roles of the Center Medical Directors.
• Identify physician recruitment needs and collaborate in the hiring and contracting of providers.
• Establish work schedules and assignments for medical staff according to workload, space and equipment and center needs.
• Oversee daily operations of physician services.
• Build strong relationships with specialists, hospitalists, SNF and other providers to form a narrow network of quality service focused on senior population health.
• Responsible for medical interpretation, reviews, and decisions as required for plan administration.
• Monitor medical performance and provide guidance to ensure that the quality of care being provided meets appropriate standards and to ensure cost-effective utilization practices.
• Oversee the development, revision, and implementation of policies and procedures, systems, programs, and standards for health care services.
• Represent the organization in community and marketing events.
• Develop and maintain compliance with the departmental and physician budgets.
• Assess, develop, and recommend strategies for compliance with regulatory requirements.
• Develop and maintain an effective relationship with all departments providing medical guidance and expertise.
• Develop, implement, and monitor the outcomes of utilization review and disease management programs to meet the quality and cost expectations.
• Identify trends of over- and under-utilization and implement action plans to improve.
• Direct and orient physicians in the correct application of approved guidelines.
• Oversee the operations of the wellness activities and medical department.
• Guide and enforce Perfect Service Standards (Customer Service).
• Other duties as requested.

Benefits

• Medical, dental and vision benefits.
• 401(k) retirement savings plan.
• Paid time off, including company and personal holidays, volunteer time off, paid parental and caregiver leave.
• Short-term and long-term disability.
• Life insurance.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Industry: Insurance Carriers and Related Activities
• Education Level: Master's degree