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Salary Range
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Job Description
Job Description
The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change.
The Health Plan of San Joaquin is now hiring an experienced, mission-driven leader to serve as our Chief Medical Officer!
Location: This is a remote position. Must reside in California within our service area to effectively support operational needs. Must be able to attend monthly onsite meetings, and other meetings as needed for business and community purposes.
At this time, The Health Plan does not sponsor visa. Candidates must have legal and valid work authorization, Green Card or U.S. citizenship.
What You Will Be Doing:
As our Chief Medical Officer, under administrative direction, you will be responsible for leading efforts that will provide innovative solutions that support more affordable healthcare, promote personal accountability for health and wellness, and offer superior service and partnerships to the constituents served by HPSJ!
Supervises
- Medical Directors
- Director of Pharmacy
- Executive Assistant
Our Vision:
Continuously improve the health of our community.
Our Mission:
We provide healthcare value and advance wellness through community partnerships.
Essential Functions:
- Identifies, develops, plans and executes short, medium and long-range strategies that drive and support corporate objectives; ensures the development and implementation of associated business plans, tactics and policies.
- Develops and oversees the implementation of medical management policies.
- Ensures that medical decisions are rendered by qualified medical personnel and are not influenced by fiscal or administrative management considerations.
- In collaboration with the Chief Heath Services Officer, will ensure consistent application of medical criteria to utilization management decision making.
- Collaborates with the Chief Health Services Officer in the strategic planning, implementation and oversight of the Quality Improvement and Quality Management Programs.
- Ensures that medical care provided meets acceptable medical care standards.
- Ensures that medical protocols and rules of conduct for HPSJ medical personnel are followed.
- Manages medical utilization through application of recognized medical and pharmaceutical guidelines and in collaboration internal and external stakeholders.
- Oversees the development and management of department budgets.
- Oversees accreditation and compliance activities to ensure agreed upon and mandated standards are met.
- In collaboration with the Chief Heath Services Officer, will identify medical delivery system quality issues; develops and oversees implementation of corrective action plans.
- Collaborates with network providers and the provider community in a manner that engenders positive relationships, provider support and network stability.
- Advises on complex, controversial and/or unique claims that are outside the realm of medical policy.
- Co-Chairs the Quality Improvement and Health Equity Transformation Committee and Chairs the Peer Review and Credentialing committee; serve on other committees as required.
- Ensures that effective collaborative work and problem-solving routines are maintained between assigned departments, and other internal and external stakeholders.
- Oversees the identification, preparation and maintenance of appropriate and required data, records and reports.
- Represents HPSJ in a manner that promotes a positive image of HPSJ in the community; serves on internal and external committees and other leadership forums.
- Promotes and maintains and ensures that direct reports promote and maintain an environment that supports HPSJ’s strategy, vision, mission and values.
- Hires, develops and retains, and ensures that line managers hire, develop and retain, a competent staff.
What You Bring:
Knowledge, Skills, Abilities and Competencies
Required
- Expert knowledge of the principles, practices and techniques of managed care, utilization management and quality.
- Knowledge of laws and regulations governing managed care.
- Expert knowledge of contemporary health issues, and the healthcare, economic or other issues affecting Medi-Cal and/or Medicare populations, providers and the underserved in
About SAN JOAQUIN COUNTY HEALTH COMMISSION