CMO (Chief Medical Officer)

ESSENTIAL FUNCTIONS:

The Chief Medical Officer (CMO) will be a seasoned and mature Board-eligible physician with at least 5-10 years of experience providing medical direction and supervision to teams of medical staff, ideally in a community-based clinic environment with more than one clinic site.

S/he must have experience developing and implementing standards of care, medical protocols, quality assurance standards and monitoring, and professional training and education. S/he must also have experience implementing new clinic operating processes and systems aimed at improving efficiency; knowledge of, and experience with, EHR and/or other related automated systems. The CMO must be committed to furthering the mission and vision for the company

KEY OBJECTIVES:

• Direct and interpret data based utilization analysis, including cost trending in key areas (inpatient, pharmacy, ED use, etc.); Review and update the utilization management policies annually; and Develop new authorization policies as needed.


• Participates in Quality initiatives, and in conjunction with the Quality Improvement Manager and Medical Director(s), completes the Quality Improvement Program Description.


• Work with the Clinical Pharmacist and medical director(s) on clinical reviews and programs; accurate documentation, along with a utilization review process, is an imperative component of the overall medical management and clinical intervention programs, the CMO must have a clear understanding of clinical documentation guidelines.


• Work with the Care Management Director and Medical Director(s) to set the clinical direction and implement disease management, care coordination and complex case management programs.


• Develop and enhance working relationships with community providers with duties including but not limited to: Evaluate disputes regarding Primary Care Physician performance; Inform and educate the professional community about the company, and its value proposition.


• Participate in all aspects of regulatory compliance related to Health Services functions with duties including but not limited to: Reviewing requirements for State and Federal audits.

KEY FOCUS:

• The CMO must have a strong working understanding of metrics and medical analytics and must ensure that data and metrics are accurate, current, well-defined and relevant.


• The CMO promotes coordination of patient care throughout the hospital experience and during the post-discharge phase.


• The CMO must lead the necessary culture change from that of the autonomous physician to that of physicians as members of a health care team.


• The CMO translates administrative imperatives to the medical staff and provides a clinical perspective to administrative vision and strategy.


• Understanding the relationship of physician documentation to final coding of the patient’s diagnoses and HCC condition codes increases the ability of the organization to be appropriately reimbursed for the services and care provided.


• The CMO needs a good understanding of the physician compensation processes, productivity incentive packages and the concept of fair-market value, both for independent and employed physicians and for individuals and groups.


• The CMO should be knowledgeable about the Stark laws.


• The key skill is the CMO’s ability to gain the trust of the various participants, to demonstrate honesty in communication and integrity in interactions.


• Alignment of physicians, and indeed of all employees, is what ultimately allows the organization to realize its strategic vision and move forward in a sustainable manner.

QUALIFICATIONS AND EDUCATION:

§ Possess a current, valid license to practice medicine in the State of Florida.

§ Board eligible in a primary care specialty; skilled and knowledgeable in all areas of general medicine.

§ Working knowledge of state-of-the-art medical, scientific and treatment methods.

§ Working knowledge of current medical, educational and psychosocial intervention procedures.

§ Experience launching medical programs and dealing with program audits.

§ Solid, proven managerial and administrative skills and expertise, preferably in environments featuring ethnically and socially diverse staff and clients, and characterized by time pressure and less-than-optimal staffing levels.

§ Creative skill, ability, resourcefulness and judgment in the analysis and solution of medical, managerial and administrative problems.

§ Experience working with information technology staff to implement and manage sophisticated practice management and/or electronic health software packages.

§ Excellent written and oral communication skills.

§ Demonstrated leadership ability, team management and interpersonal skills.

§ Excellent analytical and abstract reasoning skills, plus excellent organization skills.

§ Bilingual (Spanish/English) preferred.

§ Mental/Cognitive Demands: Establish and maintain effective work relationships with co-workers and customers, maintain regular attendance, understand and carry out a variety of oral and 5 written instructions, have knowledge of proper English usage, grammar, punctuation, spelling, and vocabulary, have the ability to learn office principles, practices, and methods, understand filing

§ systems, including numerical, alphabetical, and chronological, learn a variety of procedures, policies, and services of the assigned work unit or program, perform assigned duties with efficiency and accuracy and maintain confidentiality.

§ Travel Demands: Locally and regionally, up to 30% of the time.