CHIEF MEDICAL OFFICER – OHIO

 


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Job Summary

The Chief Medical Officer Duals is responsible for leadership of strategic medical management activities which contribute to market performance and promotes quality of care. These responsibilities include development and implementation of medical programs/policies; enhancing relationships with providers, plan sponsors and regulatory agencies and serving as a key business partner in network development, product design, strategic planning and sales support.

Essential Functions

  • Provides clinical and business leadership in support of strategic business objectives.
  • Participates in evaluation of product design; impact on quality, care and service.
  • Participates in short and long range program planning, total quality management and external relationships.
  • Responsible for the design and implementation of medical policies, goals and objectives.
  • Responsible for the development of budgets, staffing plans, assuring the adequate allocation of resources.
  • Develops and improves tools to support Aetna’s medical management programs.
  • Expands Aetna’s medical management programs to address member needs across the continuum of care.
  • Partners with other medical management functional organizations to ensure consistency and standardization of policy and procedures.
  • Develops, manages and builds teamwork among a diverse group of medical management professionals.
  • Promotes quality and medical appropriateness of care. Has responsibility for multiple medical management initiatives and achievement of desired performance.
  • Leader in improving and maintaining positive relations with providers, facilities, customers and consultants.
  • Supports sales and marketing efforts including participation in key marketing activities and presentations.
  • Key business partner in network strategy to maintain member access to high quality medical care.
  • Key contributor in the development, maintenance and support of a marketable, high quality provider network.
  • Participates in the development, implementation, maintenance and support of designated provider contracts.

Requirements:

  • M.D. or D.O. with active, unrestricted Ohio medical license
  • Current Board Certification in a recognized specialty including post-graduate direct patient care experience. Advanced degree in business or public health desirable.
  • +5 years in healthcare delivery system required with 4+ years additional leadership and management experience in managed care
  • Demonstrated ability to make strategic decisions based on a thorough understanding of healthcare industry issues, trends and the regulatory landscape
  • Ability to apply rigorous financial and value analysis to manage and enhance profitability.
  • Demonstrated ability to interact successfully with external providers.
  • Excellent leadership and interpersonal skills with a focus on collaboration with results and engaging/developing people
  • Effective and skilled public speaker and exceptional presentation skills.
  • Ability to successfully operate in a highly matrixed and changing environment.
  • Demonstrated ability to create business strategy to drive competitive advantage and shift direction as market conditions dictate.
  • Passion for maximizing healthcare quality
  • Sound clinical knowledge and recognized as a credible clinical resource.
  • Commitment to and knowledge of underserved populations, Medicaid, Medicare, Duals
  • Demonstrated commitment to service and improving constituent-focused processes

Consultant:

For additional information and/or confidential consideration, please contact Tricia French RN, BSN at tfrench@frenchgroup.com

 

The French Group, Healthcare Executive Search

477 Viking Drive, Suite 230

Virginia Beach, VA 23452

(757)362-0202