Deputy Chief Medical Officer
About the role
Kern Health Systems is dedicated to improving the health status of our members through an integrated managed health care delivery system. The Deputy Chief Medical Officer (DCMO), working under the direction of the Chief Medical Officer, will provide physician executive leadership across Kern Health Systems' clinical programs.
Responsibilities
Directly supervise and develop the Medical Directors and Senior director of Health Services, ensuring clinical and operational alignment with organizational goals.
Assist the CMO with oversight of the successful delivery of care and services for dual Special Needs Plan (D-SNP) members, ensuring compliance, quality, and positive member experience outcomes.
Provide leadership in MLR performance initiatives, driving cost management, efficiency, and sustainability through value-based strategies.
Collaborate with Health Services leadership in advancing population health, medical management, and provider performance.
Directly supervise, mentor, and evaluate Medical Directors and Senior director of Health Services.
Support the day-to-day medical care delivery system while building readiness to assume full CMO responsibilities.
Provide clinical leadership and works collaboratively with the directors of the other Departments of KHS to ensure compliance with the contractual and regulatory requirements.
Provide clinical support and education to the provider network in support of standards of care and evidence-based medicine and use of clinical criteria in decision management.
Assist the CMO with oversight of the D-SNP program delivery, including compliance with CMS requirements, member outcomes, and satisfaction.
Lead initiatives to achieve annual MLR targets and ensure financial stewardship of healthcare delivery.
Analyze clinical data and quality reports to identify trends, gaps, and opportunities for improvement.
Promote the adoption of clinical guidelines, care pathways, and best practices.
Oversee efforts to improve patient safety, clinical effectiveness, and outcomes.
Report quality outcomes and progress to executive leadership, the Board of Directors, and regulatory bodies.
Clearly communicate QI goals, progress, and results to stakeholders at all levels.
Serve as a member of the following committees of the KHS Board of Directors: EQIHEC, PAC, P&T/DUR, Quality Improvement Committee, and Grievance Committee.
Represents KHS in the medical community and in general community public relations.
Participates in the implementation of the KHS Credentialing Program.
Reviews and manages utilization of health care services at all levels of care to achieve high quality outcomes in the most cost-effective manner.
Identify areas for improvement and provide clinical leadership in the implementation of KHS Quality Improvement Plan and the Utilization Management Plan.
Lead and/or attend and actively participate in meetings and committees as assigned by the CMO.
Launch cost-containment or value-based initiatives annually with measurable ROI.
Actively Participates as a member of the Health Services management team.
Performs duties and responsibilities identified for the Medical Director under the Quality Improvement Plan, the Utilization Management Plan.
Represents KHS at regulatory, community, and provider forums when delegated by the CMO.
Serve as acting CMO during delegated absences, building leadership competency in executive-level responsibilities.
Requirements
Current, valid, unrestricted California Physician & Surgeon’s License with Board certification in area of specialty required.
Medical Doctor degree from a fully accredited university.
Advance degree in management (MBAm NGSA, etc) preferred.
Knowledge in clinical data management applications preferred.
Experience Five (5) years of active clinical practice experience required.
Eight (8) years full-time managed care administration that includes Medicare(strongly preferred), Medi-Cal experience and NCQA required.
Progressive leadership roles in managed care covering Utilization Management, Care Management, Quality Assurance.
Experience with ACO, IPA or physician group management preferred.
Health Care data analysis and use of data for monitoring outcomes and performance for programs and staff management.
Population management and HEDIS reporting.
Qualifications
Qualified applicants are considered for positions without regard to race, color, religion, sex (including pregnancy, childbirth and breastfeeding, or any related medical conditions), national origin, ancestry, age, marital or veteran status, sexual orientation, gender identity, genetic information, gender expression, military status, or the presence of a non-job related medical condition or disability (mental or physical).
Skills
Knowledge in clinical data management applications, experience in managed care administration, progressive leadership roles in managed care, experience with ACO, IPA or physician group management, health care data analysis, population management, HEDIS reporting, and experience in utilizing data for monitoring outcomes and performance for programs and staff management.
Benefits
Not specified
Pay
The Deputy Chief Medical Officer (DCMO) position is expected to pay starting compensation in the range of $308,461 - $408,710.50 annually.
Schedule
Not specified