Summary
The Value Based Care Chief Medical Officer (VBC CMO) of CMHN Clinical integrated Network reports to the CEO of CMHN, with dotted line reporting to the SVP of Value-based and Managed Care Services. The VBC CMO provides leadership, direction, and management to the CIN health centers’ medical leaders and quality improvement initiatives. VBC CMO will champion CMHN CIN’s commitment to value-based care. The VBC CMO will play a pivotal role in shaping and executing the VBC vision and strategy of CMHN CIN. This executive leader will collaborate with cross-functional teams to design, implement, and oversee innovative healthcare programs that prioritize value-based care principles.
The VBC CMO will provide strategic direction, clinical expertise, and leadership to drive excellence in patient care outcomes and ensure alignment without organization’s goals. CMO will focus on the optimization of value-based care initiatives, to include leading with emphasis on execution, outcomes, continual improvement, and performance enhancement.
Ensures consistent and continual monitoring of quality of care delivered. Oversees communication strategy to the physicians regarding measures and current performance to include supportive process improvement guidance to physicians at all levels of performance. Promotes quality improvement programs to ensure that members receive timely, appropriate, and accessible healthcare data. The VBC CMO will be responsible for identifying utilization and quality opportunities and standardizing value based clinical intervention. In this role the VBC CMO will partner with senior leadership across our Value Based Care organization as well as health centers clinical leaders to ensure the success of our Medicaid Managed Care and other value-based programs.
It is expected that VBC CMO will work with the Director of Health Equity Research to engage in research programs at CMHN and work with partner organizations to develop an extramurally funded research program at CMHN.
Minimum Qualifications
Education:
- Medical Doctor degree required
- Board Certified highly preferred
Experience:
- 5 years of experience supporting Value-Based Care.
- Significant experience in a senior leadership role within and value-based care or accountable care organization preferred.
- In-depth knowledge of population health management, care coordination, and healthcare quality improvement preferred.
- Must have a strong understanding of healthcare policy, regulations, and compliance.
- Must be able to excel within communication with ability to engage and influence stakeholders at all levels.
- Ability to drive positive clinical and financial outcomes in a value-based care environment.
- Strategic thinking and business acumen with the demonstrated ability to align clinical strategies with business objectives.
- In-depth knowledge of payor operations, managed healthcare systems, medical quality assurance, quality improvement and risk management preferred.
Minimum Knowledge, Skills and Abilities
- Creativity: Ability to generate ideas and solutions to routine challenges and new ventures.
- Leadership: Appropriately optimistic, influential, and inspiring. Willingness to lead, take charge, and offer opinions and direction.
- Resilience: Effectively manages stress and maintains adaptability and flexibility in a fast-paced setting.
- Analytical Thinking: Ability to analyze information, compare, contrast, trend data and draw conclusions.
- Critical Thinking: Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions, or approaches to.
- Communication: Ability to communicate effectively at all levels and across functions of the organization, think clearly, communicate concisely, and always collaborate.
Supervisory Responsibilities
- Population Health Management Director
Essential Functions
Clinical Strategy and Leadership
- Develop and articulate the clinical strategy in alignment with value-based care principles.
- Lead and mentor physicians to create a high-performing team of healthcare professionals.
- Drive initiatives to enhance clinical quality, safety, and patient satisfaction.
- Provides leadership and ongoing direction of clinical intervention and program strategies.
Population Health Management – In conjunction with the Population Health Management Director
- Implement and optimize population health management programs.
- Analyze data and utilize insights to develop targeted interventions for improving patient outcomes.
- Collaborate with data analytics teams to track and report on key performance indicators.
Care Coordination and Integration – In conjunction with the Director of Clinical Services
- Foster collaboration among multidisciplinary teams to ensure seamless care coordination.
- Integrate medical service across the continuum of care to enhance patient experience and outcomes.
- Identify and implement strategies to improve care transitions.
Quality Improvement – In conjunction with the Population Health Management Director
- Develop and implement quality improvement initiatives to meet and exceed industry standards.
- Utilize evidence-based practices to drive continuous improvement in clinical outcomes.
- Monitor and report on quality metrics, ensuring compliance with regulatory requirements.
- Optimize HEDIS/STARS performance; maintain oversight of utilization management.
Physician Engagement
- Cultivate strong relationships with medical staff and foster a culture of collaboration and accountability.
- Provide leadership and support to clinicians, encouraging innovation in care delivery.
- Drive physician education, clinical workflow, clinical policy, clinical playbooks in support of value-based care initiative.
Strategic Partnerships – In collaboration with the SVP of Value-based and Managed Care Services
- Collaborate with external partners, payers, and providers to enhance value-based care initiatives.
- Represent the organization in relevant industry forums and establish strategic alliances.
Research – In collaboration with the Director of Health Equity Research
- Provide leadership to various clinical research programs funded by extramural agencies.
- Collaborate with members and external partners on extramural grants and dissemination activities.
- Pursue funding opportunities to help develop a robust research program aligned with CMHN goals.
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is
- Regularly required to stand, sit; talk, hear, and use hands and fingers to handle or feel; and reach with hands and arms to operate a computer and telephone keyboard, and to reach, stoop or kneel.
- Specific vision abilities required by this job include close vision requirements due to computer work.
- Light to moderate lifting is required such as occasionally lifting office products and supplies, up to 20 pounds.
- Ability to uphold the stress of traveling.
- Regular, predictable attendance is required; including quarter-driven hours as business demands dictate.
Work Environment
- This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.
- Level of noise typical for the work environment of this job is Moderate – less than 85 decibels (business office with computers and printers and traffic within the receptionist area).
- Ability to work in a confined area.
- Ability to sit at a computer terminal for an extended period of time.
The above statements are intended to describe the general nature and level of work being performed by individuals assigned to this job. They are not intended to be an exhaustive list of all responsibilities, duties and skills required of the position. All employees may have other duties assigned at any time.
