Chief Medical Officer-
Molina Healthcare
Phoenix, AZ
See who Molina Healthcare has hired for this role
Job Summary
The Health Plan Chief Medical Officer provides leadership in the development and execution of the Plan’s disease management, case management, utilization management, and care management programs. Oversees the development of the Plan’s clinical practice guidelines and provides medical oversight and expertise in appropriateness and medical necessity of healthcare services provided to Plan members, targeting improvements in efficiency and satisfaction for members and providers.
** Position is based in Arizona
KNOWLEDGE/SKILLS/ABILITIES
- Provides leadership to the health plan in the areas of strategic planning, strategy execution and implementation of care management programs, including such programs as Quality Improvement, Utilization Management, Care Management, Predictive Modeling, and Disease Management.
- Leads the health plan's analysis of medical care cost and utilization data. Leads and manages the development of techniques to effectively correct identified and anticipated utilization problems while assuring that our members receive the care they need.
- Provides leadership, direction and oversight functions to the health plan's medical management staff designed to achieve best in class performance as defined by identified metrics.
- Offers a positive leadership role in key health plan medical management initiatives aimed at optimizing utilization of medical resources.
- Oversees and directs the rendering of medical management decisions at all levels of the health plan that maximize benefits for our members while pursuing and supporting corporate objectives.
JOB QUALIFICATIONS
Required Education
- Doctorate Degree in Medicine
- Board Certified or eligible in a primary care specialty
Required Experience
- 10+ years relevant experience, including:
- Minimum 5 years clinical practice.
- 5 years in a Medical Director role.
- 4 years HMO/Managed Care experience, including Utilization and/or Quality Program management.
- 5 years managed care administrative experience to include NCQA or URAC
Required License, Certification, Association
- Active and unrestricted Current AZ State Medical License without restrictions (free of sanctions from Medicaid or Medicare)
- Active and unrestricted current Drug Enforcement Agency Certificate
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Seniority level
Executive -
Employment type
Full-time -
Job function
Health Care Provider and Management -
Industries
Hospitals and Health Care
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See who you knowFeatured Benefits
Inferred from the description for this job
-
Medical insurance -
Dental insurance -
Vision insurance -
401(k) -
Commuter benefits -
Tuition assistance
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