Chief Medical Officer
Posted on: 24 Jan 2021
Sunrise, FL
Job Description
Position purpose: Provide medical oversight, expertise and leadership to ensure the delivery of cost effective, quality healthcare services to health plan members.
* Provide leadership and expertise in the development, implementation and interpretation of medical review and quality related policies and guidelines.
* Provide oversight and direction for staff and provider training and education.
* Promote positive relations with the local medical community, including periodic consultation with providers or prescribers.
* Review case management data, identifies trends and gaps in care and recommends corrective actions.
* Review all quality of care issues and oversees the development and implementation of processes for improvement.
* Monitor performance indicators to ensure the delivery of cost-effective care within quality standards.
* Monitor member and provider satisfaction and recommends and implements changes to improve satisfaction levels.
* Work collaboratively to develop corporate clinical care standards and medical practice policies.
* Provide medical guidance to the Medical Management department.
Education/Experience:
Medical Doctor or Doctor of Osteopathy. 7+ years of clinical experience in the practice of medicine. Management experience preferred. Utilization management experience and knowledge of quality accreditation standards preferred. Actively practices medicine and provides leadership in the local medical community. Course work in the areas of Health Administration, Health Financing, Insurance, and/or personnel Management is desired. Experience treating or managing care for a culturally diverse population preferred.
License/Certification:
Board certification in a medical specialty recognized by the American Board of Medical Specialists. (Certification in a primary care specialty preferred.) Current state license as a MD or DO without restrictions, limitations or sanctions from government programs.
This position will be supporting a Federal government contract, therefore it requires U. S. citizenship and proof of favorable adjudication following submission of Department of Defense form SF86 or higher security.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Centene
St Louis, MO
Centene Corporation operates as a diversified and multi-national healthcare enterprise that provides programs and services to under-insured and uninsured individuals in the United States. The company’s Managed Care segment offers health plan coverage to individuals through government subsidized programs, including Medicaid, the State children’s health insurance program, long-term services and support, foster care, and medicare-medicaid plans, which covers dually eligible individuals, as well as aged, blind, or disabled programs. Its health plans include primary and specialty physician care, inpatient and outpatient hospital care, emergency and urgent care, prenatal care, laboratory and X-ray, home-based primary care, transportation assistance, vision care, dental care, telehealth, immunization, specialty pharmacy, therapy, social work, nurse advisory, and care coordination services, as well as prescriptions, limited over-the-counter drugs, medical equipment, and behavioral health and abuse services.
This segment also offers various individual, small group, and large group commercial healthcare products to employers and directly to members in the Managed Care segment.Its Specialty Services segment provides pharmacy benefits management services; health, triage, wellness, and disease management services; and vision and dental, and management services, as well as care management software that automate the clinical, administrative, and technical components of care management programs. This segment offers its services and products to state programs, correctional facilities, healthcare organizations, employer groups, and other commercial organizations. The company provides its services through primary and specialty care physicians, hospitals, and ancillary providers. Centene Corporation was founded in 1984 and is headquartered in St. Louis, Missouri.
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IndustryHealthcare
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No. of Employees47, 300
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Website
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Jobs Posted349
