Chief Medical Officer Job at The Jacobson Group, Midwest, OK

V0lnOEdjMU9WYTdLVURvS3RFUE40Wnpl
  • The Jacobson Group
  • Midwest, OK

Job Description

Job Description:
Provides strategic leadership and clinical oversight for all medical directors and supports the development and implementation of medical policies and care management programs. Acts at the primary clinical advisor across medical and behavioral health operations, with a focus on quality improvement, policy development and regulatory compliance. Ensures evidence-based standards guide all utilization and appeal review activities and represents the organizations in key clinical committees and provider engagements.

Responsibilities:
  • Formulate and recommend policies relating to covered services, quality assessment and provider oversight.
  • Receive, communicate and interpret policies of the governing body to direct reports, ensuring dissemination to the appropriate staff.
  • Work closely with the Chief Executive Officer and Clinical Operations Officer on matters related to interdepartmental coordination within the clinical aspects of the company.
  • Serve as the plan's principle liaison and represent the plan in meetings with providers to facilitate collaborative efforts to improve patient care.
  • Serve on various committees, task forces and special project teams of the plan.
  • Provide leadership and management to ensure effectiveness of medical policies by maintaining ongoing evaluation of the provider communities' quality of care and managed care educational needs.
  • Participate in the interview and hiring process for key clinical staff positions, including but not limited to, all nursing leadership positions and all medical directors.
  • Devote approximately 50 percent of time to quality-related activities.
  • Present and interpret utilization data both internally and externally.
  • Develop and manage medical policies and procedures and ensure compliance with them.
  • Advise and assist the networks and physicians in ensuring the effectiveness of programs and meetings.
  • Work closely with health systems to align policies and goals to improve quality and increase efficiency.
  • Ensure the organization has qualified clinicians accountable for decisions affecting consumers.
  • Remain available for real-time consultation and to be a resource for the nurse reviewers' determinations.
  • Render determinations on medical or drug utilization management cases under appeal.
  • Ensure compliance with federal and state laws, regulations and standards of regulatory or certifying organizations.
  • Implement sanctions where indicated by regulatory or accrediting bodies.
  • Performs other duties as assigned.
Requirements:
  • Demonstrated leadership abilities within large and complex healthcare organizations
  • Well-developed interpersonal skills with the ability to interpret complex information from a variety of sources
  • Creative, energetic individual with strong public relations abilities
  • Professional demeanor with a positive attitude and self-motivation
  • Previous experience in discharge planning, care coordination or case-management 
  • Experience working with complex data, including management, reporting, visualization and communication
  • Successful completion of healthcare sanctions background check
  • Ability to speak and write fluently in English
  • Graduation from an accredited medical school
  • Residency trained in medical discipline
  • 5+ years of experience in post residency clinical practice
  • 10+ years of experience as a health plan medical director or Chief Medical Officer
  • Current, active, unrestricted license to practice medicine in Oklahoma
  • Board certified; certification must be maintained
  • Additional management training strongly recommended – master's degree in a related field (preferred)
  • License must be of type and scope that permits clinical judgment in utilization review determinations
  • Must be licensed as either a Doctor of Medicine or Doctor of Osteopathic Medicine


Contact:
Sal Monteleone
smonteleone@jacobsononline.com

Job Tags

Similar Jobs

SMP Engineering

Mechanical/Solidworks Designer (Sheet Metal) Job at SMP Engineering

 ...Solidworks Designer/Drafter (In-Office Position) About SMP Engineering: In a nutshell, we work on the hard stuff. Our customers come to us to quickly engineer, cost-effective solutions to a wide range of technical challenges. These include product development and... 

FDR Financial Group

Software Engineering Summer Internship Job at FDR Financial Group

 ...Description FDR Financial Group is offering a full-time remote Summer Internship opportunity for Entry-Level Software Engineering enthusiasts in the Financial Services industry. As a Summer Intern, you will have the chance to gain hands-on experience in software development... 

Pearson

American Sign Language Specialist Job at Pearson

**This is a 6 month Limited Term Role.**The American Sign Language Specialist supports the review of educational content which has been...  ...linguistic accuracy, including proper sign production, facial expressions, body language, and non-manual markers+ Verify the accuracy... 

TAD PGS, Inc.

A&P Mechanic Job at TAD PGS, Inc.

 ...Plainfield, IN surrounding area.Responsibilities:~Perform all work assignedin accordance withapproved FAA data.~Structural Repair & Composite repair experience is a requirement.~Ensure complete and proper documentation of work performed.~Ensure that all maintenance is... 

Trinity Employment Specialists

Bank Teller Job at Trinity Employment Specialists

 ...Full-Time Bank Teller Needed in Broken Arrow! Pay: $15/HR MondayFriday 8:45am 5:45pm Every third Saturday 8:45am12:15pm If you have 1-2 years of strong work history in customer service, please apply! Qualifications: High school diploma or GED required...