Position:
Chief Medical Officer - Regional Operations
Position Summary:
The Chief Medical Officer (CMO), Regional Operations is a key member of the Lumeris Clinical Team. The Regional CMO functions in a clinical operations role as a member of the operations team and serves as the clinical lead for Lumeris' unique Provider Population Health Services Organization (PHSO) operating partnerships with Health Systems and Physician Organizations. The Regional CMO collaborates across a matrixed entrepreneurial culture to provide clinical and population health management expertise, leadership and strategy specifically focusing on clinical operations, physician leadership and engagement, clinical practice transformation, care delivery model design, and execution.
Job Description:
Primary Responsibilities:
- Provides clinical leadership in the development, organization and governance of a clinically integrated network (CIN) of physicians or Population Health Services Organization.
- Responsible for leading the improvement of clinical, quality, and financial outcomes for the operating partnerships.
- Provides change management expertise in health systems, provider organizations, and physician practices.
- Participates in the alignment of physician incentives, quality measures, and value-based contracts.
- Maintains strong relationships with Provider PHSO Medical Directors and clinical leaders at partnering organizations.
- Directs and monitors medical management activities and quality management programs as needed to maintain compliance with CMS, NCQA and other accrediting bodies.
- Collaborates with the Provider Engagement team to move physician offices to accountable care model.
As a Member of the Lumeris Clinical Team the Regional CMO will:
- Collaborate with the Corporate Chief Medical Officer (CCMO) on clinical strategy, design and approach, facilitating communications, and managing risk on active engagements by:
- Acting as an internal consultant on clinical program development and special projects for Lumeris customers.
- Participating in ongoing product development activities related to Lumeris technologies and services.
- Providing timely, proactive communications and progress reports to the CCMO, the Clinical Leadership Team and other key stakeholders regarding Lumeris activities and external client status.
- Providing support to the Accountable Delivery Systems Institute as needed on matters relating to accountable care, physician engagement/alignment, payer and clinical transformation, and the use of leading technology in support of the new models of care.
- Participating in business development meetings with prospective clients to present the Lumeris value proposition.
- Support the Lumeris Advisory Services team in content development and supporting the delivery of V2Vs.
- Contribute to the Clinical thought leadership of the organization through presentations, case studies and scientific articles.
Reporting Relationship:
The CMO-Regional Operations reports directly to the Senior Vice President, Delivery and Operations with a matrixed reporting relationship to the Corporate Chief Medical Officer. The CMO-Regional Operations is an active member of the Lumeris Clinical Leadership Team.
Qualifications:
- MD. or D.O. degree, plus Board Certification.
- MBA or Master's Degree in healthcare or other related field preferred.
- Current, unrestricted medical license.
- Minimum of five years successful clinical practice experience.
- Minimum of three years of health system, health plan or capitated provider experience with exposure to managing total cost of care, quality, and documentation and coding.
- Minimum of three years of population health or managed care experience.
- Strong background in administrative clinical leadership.
- Solid understanding and experience with population health management strategies.
- Prior operational consulting experience a plus.
- Knowledge of healthcare financing and the relation to various managed care products (HMO, PPO, Indemnity, and Medicare Advantage).
- Government sector experience a plus (Medicare or Medicaid products).
- Knowledge of continuous quality improvement theory and practice.
- Excellent communication and problem-solving skills.
- Demonstrated track record of building productive working relationships with subordinates, peers, senior management, and external customers.
- High level of energy and drive.
Working Conditions:
- While performing the duties of this job, the employee works in normal office working conditions.
Disclaimer:
The job description describes the general nature and level of work being performed by people assigned to this job and is not intended to be an exhaustive list of all responsibilities, duties and skills required. The physical activities, demands and working conditions represent those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job duties and responsibilities.
Lumeris is an EEO/AA employer M/F/V/D.
The hiring range for this position is:
Factors that may be used to determine your actual pay rate include your specific skills, experience, qualifications, location, and comparison to other employees already in this role. This role may also be eligible for incentive compensation. At Lumeris, we are committed to providing a total rewards package that supports your overall well-being. Our benefits include medical, vision, dental, well-being programs, 401(k) with company matching, life insurance, paid time off including paid leave, and so much more.
Member Facing Position:
No- Not Member or Patient Facing Position.
Location:
New Jersey.
Time Type:
Full time.
Lumeris and its partners are committed to protecting our high-risk members & prospects when conducting business in-person. All personnel who interact with at-risk members or prospects are required to have completed, at a minimum, the initial series of an approved COVID-19 vaccine. If this role has been identified as member-facing, proof of vaccination will be required as a condition of employment.
