Chief Medical Officer
3 weeks ago
Integrated Healthcare Partners (IHP) is a not-for-profit organization working in partnership with the RI Executive Office of Health and Human Services as well as with local managed care organizations. IHP is comprised of participating providers including Community Health Centers and Community Mental Health Centers. IHP works in partnership with our participating providers to improve individual and population health outcomes, decreasing unnecessary medical spending, and connecting individuals to high quality services and supports over 32,000 covered lives.
This is primarily a remote position, but the selected candidate must reside in the general Rhode Island or Massachusetts area. The position requires attending meetings at worksite locations in Rhode Island.
The Chief Medical Officer is responsible to participate in the implementation of IHP's strategic road map, HSTP plan, and quality initiatives under the direction of the CEO of IHP. The incumbent will work in partnership with certain board committees and staff and support IHP's mission to positively impact the quality of services and total cost of care.
The incumbent will assist in the development and implementation of annual and long range Quality Improvement Plans that directly align with meeting key deliverables for Total Cost of Care Shared Savings as well as HSTP Incentive revenue for all IHP participating providers. Key responsibilities include ongoing risk assessment with clear mitigation strategies, routine updates to IHP Accountable Entity Dashboard, quality assurance and review of programs impacting IHP's success.
The incumbent will be responsible for providing recommendations and drive initiatives targeted on improving individual and population based health outcomes and driving down unnecessary medical expenditures.
Lastly, the incumbent serves as the manager to IHP's Clinical Healthcare Analyst. The incumbent ensures that all key deliverables and responsibilities of the Clinical Healthcare Analyst are met in a timely manner.
Significant Job Functions:
- Reviews actionable data at individual and population-based levels for opportunities to improve health outcomes and drive down TCOC. This includes reviewing member lists and ensuring they are actively engaged in care and reviewing data including but not limited to Pharmacy, Avoidable ED, Labs, Radiology.
- Assists in leading Clinical Leadership Committee and driving HSTP project initiatives and programming
- Works across the AE to launch impactful programming using clinical expertise e.g. integrated care, SUD treatment, MAT programming with a focus on Alcohol Related Disorders, SDOH and linking to appropriate interventions and supports, and other areas of focus
- Will assist in readiness planning and implementation for taking on delegated functions of care management from managed care organization partners.
- Develops and assists rolling out initiatives to improve overall quality performance across the AE.
- Policy development, implementation, and assure adherence to all policies and procedures pertinent to the operations of IHP.
- Responsible for the implementation and reporting efficaciousness of new and ongoing policies, procedures, and/or programs that meet year over year program deliverables, improve quality performance, and health outcomes for all attributed members.
- Other duties as agreed upon by CEO of IHP and the incumbent.
Required Qualifications:
- Medical Doctor or Doctor of Osteopathy with full, unrestricted RI medical license.
- Excellent written, oral, and presentation skills.
- Collaborative leader with experience developing, implementing, and evaluating innovative clinical programs that have improved quality and efficiency of care.
- Recent eight to ten plus years of experience in health care delivery, insurance, managed care, and quality.
- Knowledge of, and/or experience with, the US Public Health Service Community Health Programs, CMS Regulations, and RI state regulations and policies.
- Rhode Island Medicaid expertise required.
Physical Effort/Environment: General office environment. No extreme physical demands. Transportation needed for on-site meetings.
Work Schedule Demands: Part time, fully remote (6-10 hours, plus per week). Occasional evenings and some weekend work may be necessary for meetings, conferences, etc.
Communication Skills Required: Exceptional oral and written skills needed. Proficient in health management terminology, including information and billing systems terminology, contractual language, tort language, some medical terminology, financial terminology, and federal and state public health program terminology.
Confidentiality of Information: Full access to information.
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