Job Description
Are you a passionate and experienced physician leader specializing in behavioral health? Do you dream of making a real difference in the lives of individuals and communities? If so, we have an exceptional opportunity for you to join our team as a Senior Medical Director (CMO) in beautiful New Mexico!
About the Role:
As the Senior Medical Director, you will be the clinical visionary for our health plan, overseeing all lines of business (Medicaid, Medicare, and Commercial). This is a remote position based in New Mexico, where you'll have the chance to shape the future of behavioral healthcare. You will:
Lead the development and implementation of clinical programs that support our vision for integrated and holistic care.
Ensure the delivery of high-quality, cost-effective healthcare through oversight of service coordination, utilization management, care/case management, population health/disease management, and quality improvement programs.
Champion parity efforts, ensuring compliance and driving positive change in access to mental health and substance use disorder services.
Analyze data to identify opportunities for improvement in utilization, quality, and cost of care.
Mentor and guide a team of Medical Directors and Physician Advisors.
Build strong relationships with providers, health plan partners, members, and state agencies.
Represent our organization in the community and with key stakeholders.
Provide clinical leadership to the interdisciplinary Medical Management team, offering guidance and training to care managers.
Ensure the quality of utilization review determinations, including appeals, and conduct peer-to-peer reviews.
Evaluate the effectiveness and cost of clinical programs, making data-driven adjustments as needed.
Collaborate with external stakeholders, including health plan partners and state government agencies.
Lead and participate in Quality Improvement (QI) programs, driving initiatives that enhance the quality of care.
Recruit, train, supervise, and mentor medical staff and physician advisors.
Develop and manage budgets for medical directors, physician advisors, and continuing medical education.
Develop and implement Medical Action Plans (MAPs) to address cost of care and improve utilization and quality metrics.
Contribute to the development and implementation of medical policies and clinical guidelines.
Assess technology and clinical practice standards, ensuring consistency in reviews and care plans.
Collaborate with the network management team on an integrated clinical-network approach.
Provide after-hours coverage as needed.
Participate in RFP response development.
What We're Looking For:
Targeted specialties: Psychiatry, Psychiatric sub-specialty, Primary Care, Geriatrics, Palliative Care, or Physical Medicine.
Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) degree, or equivalent international medical degree with required US training and licensure.
Graduation from an accredited American or Canadian medical school or equivalent foreign medical school with required US certifications.
Completion of a US or Canadian residency program approved by the Accreditation Council for Graduate Medical Education (ACGME).
At least 7 years of post-residency experience involving substantial direct patient care.
Clinical experience relevant to the patient population being managed.
Unrestricted current and valid medical license in New Mexico.
Strong leadership skills and ability to drive change.
Experience with cost-benefit analysis, medical decision analysis, credentialing, quality assurance, and continuous quality improvement (CQI) processes.
What We Offer:
Competitive Compensation: A generous salary range reflecting your experience and expertise.
Comprehensive Benefits: A full range of benefits designed to support your well-being.
Impactful Work: The opportunity to make a tangible difference in the lives of others.
Collaborative Environment: A supportive and collaborative team dedicated to improving behavioral healthcare.
Remote Work: The flexibility to work from your home in New Mexico.
Join Our Team:
If you're a passionate and experienced physician leader seeking a rewarding opportunity to shape the future of behavioral healthcare, we encourage you to apply!
Employment Type: Full-Time
Salary: $ 287,795.00 Per Year
Job Tags
Full time, Work from home,