Chief Medical Officer, ACO Strategy & Growth

Atlantic Health System; Morristown (NJ); On-site; USD 350,000 - 550,000; Full time

Job summary

Atlantic Health System invites applications for the ACO Chief Medical Officer role based in Morristown, NJ. The CMO will drive population health initiatives, utilization management, and quality improvement across Atlantic ACOs, partnering with the Associate CMO to execute a broad clinical and operational portfolio.

The candidate will lead patient-centered care improvements, manage data and analytics platforms, and shape payer strategies while collaborating with executive leadership to advance

Responsibilities

• Provide leadership, direction, and support in the development and management of ACO daily operations, including utilization management, care management, credentialing, and network development.
• Lead the development and implementation of the utilization management program.
• Provide leadership and support to all operational committees and task forces of the ACO.
• Participate in executive management business and clinical strategy development and implementation.
• Build and leverage cross-functional collaborative relationships with key stakeholders to achieve shared ACO goals.
• Develop and implement strategic goals related to quality improvement.
• Oversee outcomes for the ACO's beneficiary population.
• Remain informed about political, government, insurance, and local practice developments affecting physicians and the ACO.
• Maintain awareness and understanding of emerging models in health care delivery; identify and define new and innovative strategies to achieve the business goals and objectives of the ACO.
• Work collaboratively with Integrated Care to support complex case management, rising risk, and post-acute care initiatives.
• Ensure physicians and providers have the tools and education they need to understand financial risk, and that physician and ACO leaders have metrics to identify and react quickly to outlier activity including data to promote preventive care, manage chronic disease, identify ambulatory-sensitive conditions, and achieve payer utilization requirements.
• Post-acute cost is a growing concern among payers and a significant opportunity for our ACOs to affect cost and quality.
• Apply thoughtful approaches to prior authorization, concurrent review, and medical necessity criteria; equip ACO physicians and providers with the tools and education to manage post-acute admissions and length of stay; and support and optimize the post-acute care network strategy.
• Risk scoring is a key opportunity to increase revenue for ACO and for individual practices. Support practices to ensure proper coding of complex conditions and close gaps in care supporting value-based contract goals.
• Provide direction and support for the ACO's arrangements with payers.
• Assist with analytics and the development of quality measures for new value-based and risk-based payment models.
• Work collaboratively with executive leadership to design, negotiate, and monitor payment arrangements with payers.
• Participate in payer joint operating committee meetings and other clinical and financial review sessions.
• ACO Performance Improvement Committee and ACO Boards — practice selections, messaging, and accountability parameters for performance year.
• Review of the Atlantic Health risk readiness assessment.
• Payer negotiations — terms, strategies, carve-outs, opportunities, and proforma design.
• Remediation and remuneration discussions with Innovaccer; ACO EHR vendor quality reporting.
• Integrated Care Team
• ACO Clinical Pharmacist oversight
• Assist ACO President and COO with identifying needed ACO positions and roles, and budget considerations

Job description

Atlantic Health System invites applications for the ACO Chief Medical Officer role based in Morristown, NJ. The CMO will drive population health initiatives, utilization management, and quality improvement across Atlantic ACOs, partnering with the Associate CMO to execute a broad clinical and operational portfolio.

The candidate will lead patient-centered care improvements, manage data and analytics platforms, and shape payer strategies while collaborating with executive leadership to advance