Job Description
Are you a passionate and experienced physician leader specializing in behavioral health? Do you envision yourself shaping the future of mental healthcare delivery in New Mexico? If so, we have an exceptional opportunity for you to join our team as a Senior Medical Director (CMO)!
About the Role:
As our Senior Medical Director, you'll be the clinical visionary for our health plan in New Mexico, leading all lines of business (Medicaid, Medicare, and Commercial). You'll champion our clinical vision, implementing and managing programs that ensure our members receive the highest quality, most effective care. This role is fully remote within New Mexico, offering you the flexibility to work from anywhere in the state.
What You'll Do:
Clinical Leadership: Provide clinical leadership to our interdisciplinary Medical Management team, offering guidance and support to our dedicated professionals. You'll oversee the quality of utilization review determinations, including appeals, and conduct peer-to-peer reviews.
Program Development & Oversight: Ensure the effectiveness and cost-efficiency of our clinical programs through data analysis and evaluation. You'll develop and implement medical action plans to address cost of care and quality metrics, collaborating closely with the clinical care management team.
Stakeholder Engagement: Build and maintain strong relationships with external stakeholders, including key health plan partners, state government agencies, and regulators. You'll represent our organization at meetings and deliver presentations on important initiatives.
Quality Improvement: Lead and participate in Quality Improvement programs, ensuring compliance with goals and driving continuous improvement in the quality of care we provide. You'll oversee quality of care concerns, adverse incidents, and the clinical service delivery system.
Provider Collaboration: Work closely with our network management team to foster an integrated clinical-network approach. This includes visiting providers and attending meetings to ensure collaborative relationships.
Mentorship & Management: Recruit, train, supervise, mentor, and evaluate medical staff and physician advisors. You'll manage budgets related to these areas.
Policy & Compliance: Ensure compliance with medical policies, clinical guidelines, and quality operations policies. You'll participate in medical policy and clinical guideline committees, providing input and conducting research.
What You'll Bring:
MD or DO degree, or MBBS international degree with required US training and certifications.
Completion of a US or Canadian residency program.
7+ years of post-residency experience with substantial direct patient care.
Clinical experience relevant to the patient populations being managed (Psychiatry, Psychiatric sub-specialty, Primary Care, Geriatrics, Palliative Care, or Physical Medicine preferred).
Unrestricted medical license in New Mexico.
Strong leadership skills with the ability to drive change.
Experience with cost-benefit analysis, medical decision analysis, and quality improvement processes.
What We Offer:
A competitive salary range designed to attract top talent.
Comprehensive benefits package including health, life, and voluntary options.
Opportunities for professional growth and development.
A supportive and collaborative work environment.
The chance to make a real difference in the lives1 of New Mexicans.
Employment Type: Full-Time
Salary: $ 287,795.00 Per Year
Job Tags
Full time, Remote job,