CHIEF MEDICAL OFFICER, SENTARA HEALTH PLANS (VIRGINIA)
Headquartered in Virginia Beach, VA, Sentara Health Plans is the health insurance division of Sentara Healthcare, offering health plans through its subsidiaries, Optima Health and Virginia Premier. Collectively, Optima Health and Virginia Premier provide health insurance coverage to over 925,000 members, producing nearly $6 billion in revenue, through a full suite of commercial products including consumer-driven, employee-owned and employer-sponsored plans, individual and family health plans, employee assistance plans and plans serving Medicare and Medicaid enrollees.
The Chief Medical Officer of Sentara Health Plans, as an integral part of the Senior Leadership Team, is responsible for providing medical and clinical operations oversight, expertise and leadership to ensure the delivery of cost effective, quality healthcare services to our health plan members.
The CMO provides vision and leadership to the health plans in the areas of strategic planning, strategy execution and implementation of care management programs, including such programs as Quality Improvement, Utilization Management, Care Management and Population Health. She/he builds and promotes strong synergies with other internal stakeholders to identify, support and implement cost of care initiatives for all lines of business. The CMO works closely with Network Management to support strong provider relations and robust deployments of innovative provider-facing, value-based care programs and reimbursement structures. The CMO collaborates and participates on clinical committees within the broader Sentara Healthcare medical community and promotes positive relations with the local medical community. In addition, she/he provides leadership and expertise in the development, implementation and interpretation of medical policy and quality-related policies and guidelines. The CMO also supports evaluation of inorganic and organic growth opportunities.
The successful candidate must be able to drive innovation, create alignment across the organization and deliver on the commitment of assuring the best possible care for our members while maintaining affordability and superior access to care. The CMO will have a strong focus on leveraging the unique opportunities that exist with Sentara Health Plans as an Integrated Delivery Network (IDN). A key component for success in this role will be to maximize our IDN structure for the sustained benefit of our members and our provider communities. She/he will also possess demonstrated extraordinary leadership and executive decision making, in a high-growth, results-driven, and highly-matrixed environment.
This is a highly visible and strategic position requiring exceptional leadership skills and substantial experience as a physician executive. The CMO is a critical medical and business leader and contact for external providers, plan sponsors, and regulatory agencies; thus, requiring superior interpersonal, negotiation, influencing and presentation skills. The CMO must have a successful track record for oversight and management of clinical operations with a proven ability to lead and promote accountability. The successful candidate will also have strong strategic and analytical skills with a proven ability to lead change within a highly-matrixed organization.
Qualifications And Skills
- M.D. or D.O. degree from an accredited institution and current Board-Certification in an American Board of Medical Specialties-recognized specialty
- Active, unrestricted license to practice medicine in at least one state, with the ability to obtain Virginia licensure
- 10+ years of post-residency experience in clinical care and health plan and health system leadership including experience with Medicaid, Medicare and commercial products.
- Experienced at developing sucessful clinical strategies and familiarity with current medical issues and practices and the nuances of working within an Integrated Healthcare Delivery Network
- Proactive in identifying opportunities to capture value with proven ability to understand how to best deploy resources to positively impact outcomes.
- Familiar with all aspects of health plan operations, especially as related to various state and federal quality measurement and cost efficiency programs. Understands laws and other regulatory bodies impacting health plan operations.
- Successful leadership experience within a highly matrixed organization and adept at collaborating cross-functionally to drive positive change in value-based health care initiatives.
- Inspirational leadership style with exceptional staff development, team-building and mentoring skills. Thrives on building high-performing, inclusive and self-directed teams. Values and promotes a culture of accountability and leading with purpose.
- Innovative, multi-dimensional thinker and executor who moves fluidly between creative problem-solving, critical thinking and strategic thinking, and operational execution.
Tricia French RN, BSN
President & CEO
The French Group