VICE PRESIDENT CHIEF MEDICAL INTEGRATION OFFICER – SOUTHEAST HEALTH PLAN

The Chief Medical Integration Officer is responsible for leadership of strategic medical management activities which contribute to market performance and promote 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.

ADDITIONAL RESPONSIBILITIES

• Facilitates the identification and dissemination of evidence-based clinical protocols to reduce variation in care and improve quality and efficiency.

• Translates the medical management goals required by health plan contracts into care processes and metrics. Monitors actual performance to contractual goals.

• Evaluates utilization, efficiency, and quality measures of providers and populations. Develops strategies for improvement, reviews performance and plans adjustments when necessary.

• Identifies current and developing national and regional trends of value based payment models

• Participates in the development and implementation of decision-support tools to assist in value based programs and risk sharing contract management.

BACKGROUND/EXPERIENCE DESIRED

This is a highly visible and strategic position requiring exceptional collaboration and leadership skills with substantial experience as a physician executive. The VP Medical Integration is a critical medical and business leader thus requiring superior interpersonal, negotiation, influencing and presentation skills. In addition to having significant health plan experience and a passion for quality and integrated care, the VP Clinical Integration will also have an understanding of medical analytics/reporting and value-based payment models.

EDUCATION REQUIREMENTS

• M.D. or D.O. with active, unrestricted medical license

• Current Board Certification in an ABMS recognized specialty – primary care preferred

• MBA, MPH, MHS, or MHA preferred

• +5 years in healthcare delivery system required with 4+ years additional leadership and management experience in managed care

• Commitment to and experience with underserved populations, Medicaid, Medicare, Duals

CONSULTANT

Tricia French RN, BSN

President & CEO

The French Group

(757)362-0202

tfrench@frenchgroup.com