Chief Medical Officer MD

We are looking for our next Chief Medical Officer (MD) to lead our Health Services Division.
This position is available in either our Merced, Salinas or Scotts Valley office. In order to be successful in the position, it requires a local presence and connection to a local office.
PURPOSEFUL WORK
***. works in partnership with our contracted providers to promote prevention, early detection and effective treatment, and improve access to quality health care for those we serve. This results in the delivery of innovative community-based health care services, better medical outcomes and cost savings.
We are 500-ish employees who are all working towards our vision of Healthy People, Healthy Communities by living out our values of Equity, Integrity, Improvement and Collaboration in the pursuit of our mission of accessible, quality health care guided by local innovation.
LEADERSHIP WITH
Reporting to the CEO, Stephanie Sonnenshine, the Alliance’s CMO is part of the executive leadership team. The CMO works closely with the other division chiefs; Van Wong, Chief Operating Officer; Scott Fortner, Chief Administrative Officer; Lisa Ba, Chief Financial Officer; and our soon-to-be-filled Chief Information Officer.
LEADERSHIP OF
The CMO has eight direct reports, which are four Department Directors, three Medical Directors and one Administrative Specialist. The CMO has strategic leadership of the following Departments and their respective functions:

1. Community Care Coordination
   which consists of the new Enhanced Care Management program, Behavioral Health oversight and Care Coordination
2. Quality Improvement and Population Health
   which consists of the QI team that works on Facility Site Review, Practice Coaching and HEDIS, along with the health education and cultural and linguistic services team
3. Pharmacy
   is comprised of a team that performs medication coordination and provider education, after the Medi-Cal Rx Carve-Out
4. Utilization Management and Complex Case Management
   which consists of Authorizations and Transportation, Prior Authorizations, Concurrent Review, and Complex Case Management for adult and pediatric members
5. Medical Affairs
   is a consultative group of three Medical Directors who work closely with the other departments in the Division. One of the Medical Directors will be our current CMO, Dr. Dale Bishop who is taking an intentional step towards retirement into this position, once the CMO is filled.

WHAT YOU'LL BE RESPONSIBLE FOR
Reporting to the Chief Executive Officer, Stephanie Sonnenshine, you will lead the Health Services Division, which is one of our largest teams at 175 employees. The CMO:

1. Provides executive management and leadership of the Alliance Health Services Division, which includes the Quality Improvement and Population Health, Pharmacy, Utilization Management and Complex Case Management, and Community Care Coordination Departments.
2. Provides executive leadership related to new business plans, policies, programs and projects to ensure high quality results
3. Participates in strategic planning and goal setting for the Alliance
4. Ensures the quality of services provided to Alliance members
5. Oversees all aspects of the Utilization Management program to ensure appropriate utilization, adherence to program criteria and program performance
6. Ensures the care coordination of services provided to Alliance members

THE IDEAL CANDIDATE WILL

1. Be a purpose-driven leader, adept at achieving alignment towards shared goals, and delivering results through shared effort
2. Have excellent leadership skills paired with Medi-Cal experience and excited about the upcoming opportunities through CalAIM
3. Be committed to equity and interested in system redesign to produce health as an outcome
4. Enjoy working on a team, both with your peer Chiefs and with the Alliance executive leadership team as a whole.
5. Be an effective communicator, promoting authentic, direct and timely communication within your own team and across the organization.

WHAT YOU'LL NEED TO BE SUCCESSFUL
In terms of your experience, we don’t expect you to come with direct oversight or experience of each department that you’ll lead, but we will need you to understand the desired outcome from each area and to be able to monitor performance and address any areas of opportunity. You’ll support the Directors in executing their work, empowering them to lead and be experts in their own areas.
Education and Experience:
Doctor of Medicine, current license to practice medicine issued by the State of California, Board certification in a specialty recognized by the American Board of Medical Specialties;
Twelve years of experience in a medical programs administration role in an organized health system, which included experience leading or consulting with one or more of the operational areas overseen by the Chief Medical Officer; or an equivalent combination of education and experience may be qualifying.
Knowledge of:
Managed care, clinically and administratively, as well as familiarity with the California Code of Regulations
California Medi-Cal and Medicare, NCQA and CMS standards, Quality Improvement studies, and HEDIS reporting
Public policy and regulatory issues in health care
Ability to:
Oversee and measure the performance of a broad range of functional areas, including health services administration, quality improvement and population health, pharmacy, utilization management, and complex case management, and community care coordination
Review and assess overall division function, including the core work, goals and structure of each department, and oversee the directors’ development and implementation of short- and long-term planning to achieve strategic objectives and completion of annual department strategic planning related activities
Identify new programs, processes and systems to improve productivity and results
Direct, manage, supervise, mentor, train, and evaluate the work of staff, and assist department directors in doing so
OTHER DETAILS
While this position is connected to one of our Alliance offices, we are in a fully telecommute work environment right now due to the COVID-19 pandemic. The interview and on-boarding process for this position will be completed remotely.
This position may require onsite presence when our offices re-open, which will be no sooner than February 1, 2022. Onsite presence will most likely be on a part-time basis, but is dependent on business needs.
This position works across our three counties and regular travel is expected in support of our relationships, regular meetings and provider partnerships in each county.
COVID-19 Vaccination Requirement:
This position requires staff to be fully vaccinated upon their start date as a condition of employment. Proof of vaccination must be submitted at time of hire. Fully vaccinated is defined as the receipt of:

• The second dose in a 2-dose series (Pfizer & Moderna vaccines); OR
• Receipt of a single-dose vaccine (Johnson & Johnson); OR
• A combination of the required doses outlined here through the CDPH order AND Receipt of a booster (if eligible); AND A two-week period having passed since the administration of the last vaccine dose.

OUR BENEFITS
Medical, Dental and Vision Plans
Ample Paid Time Off
11 Paid Holidays per year
401(a) Retirement Plan
457 Deferred Compensation Plan
Robust Health and Wellness Program
EV Charging Stations
And many more
ABOUT US
We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us.
Join us at (the Alliance), where you will be part of a culture that is respectful, diverse, professional and fun, and where you are empowered to do your best work. As a regional non-profit health plan, we serve over 377,000 members in Santa Cruz, Monterey and Merced counties. To learn more about us, click here.
At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for any type of employer supported or provided sponsorship.#J-18808-Ljbffr