Chief Medical Officer, Health Plan (Based in AZ)

Molina Healthcare; United States; On-site; USD 246,251 - 480,190; Full time

Benefits offered by this job

Competitive benefits and compensation package

Job summary

A leading healthcare organization is seeking a Chief Medical Officer to provide executive-level leadership for their health plan based in Arizona. The role involves overseeing care management programs and ensuring quality member services. To qualify, candidates need at least 12 years of relevant health care experience, an active medical license in Arizona, and exceptional leadership and communication skills. This full-time executive position offers a competitive salary range of $246,251.34 - $480,190.11 annually, depending on experience and education.

Qualifications

• At least 12 years of relevant health care leadership experience.
• Active and unrestricted MD or DO license in Arizona.
• Experience in managed care organization.

Responsibilities

• Provide strategic leadership for medical affairs function.
• Oversee medical management staff performance.
• Direct medical management decisions for the health plan.

Skills

Leadership skills

Communication skills

Financial acumen

Decision-making ability

Education

Doctor of Medicine (MD) or Doctor of Osteopathy (DO)

Board certification

Tools

Microsoft Office

Job description

Chief Medical Officer, Health Plan (Based in AZ)

Join to apply for the Chief Medical Officer, Health Plan (Based in AZ) role at Molina Healthcare.

JOB DESCRIPTION: Job Summary. Provides executive-level strategy and leadership to the health plan in the development and execution of care management and utilization management programs. Develops clinical practice guidelines and oversees appropriateness and medical necessity of services provided to plan members, targeting improvements in efficiency and satisfaction for members and providers. Partners with executive leadership to provide cohesive direction toward company goals, ensuring member progress toward desired outcomes and contributing to overarching strategy to provide quality and cost‑effective member care.

Essential Job Duties

• Provides executive strategy, vision and direction to the health plan for the medical affairs function. Provides strategic support for design/implementation/execution for programs related to quality improvement, utilization management, care management, predictive modeling and disease management. Responsible for performance and financial results of medical affairs function, and keeps executive leadership apprised.
• Leads the health plan's analysis of medical care cost and utilization data. Leads and manages the development of techniques to effectively correct identified and anticipated utilization problems while ensuring that members receive the care they need.
• Provides leadership, direction and oversight functions to the health plan’s medical management staff to achieve best‑in‑class performance as defined by identified metrics.
• Demonstrates a positive leadership role in key health plan medical management initiatives aimed at optimizing utilization of medical resources.
• Oversees and directs the rendering of medical management decisions at all levels of the health plan that maximize benefits for members while pursuing and supporting corporate objectives.

Required Qualifications

• At least 12 years of relevant health care leadership experience, including clinical practice experience, and at least 2 years as a medical director in a managed care organization supporting utilization management/quality program management, or equivalent combination of relevant education and experience.
• At least 7 years of health care management/leadership experience.
• Active and unrestricted Doctor of Medicine (MD) or Doctor of Osteopathy (DO). License must be active and unrestricted in state (AZ) of practice.
• Board certification.
• Working knowledge of applicable national, state, and local laws and regulatory requirements affecting medical and clinical staff.
• Experience demonstrating strong leadership and communication skills, consensus building, collaborative ability and financial acumen.
• Demonstrated ability to make strategic decisions.
• Excellent verbal and written communication skills.
• Microsoft Office proficiency.

Preferred Qualifications

• Certified Professional in Healthcare Management (CPHM), Certified Professional in Healthcare Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of America (CMSA) certification, or other health care or management certification.
• Prior experience with process improvement activities, policy and procedure development, and operational efficiency.

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $246,251.34 - $480,190.11 / ANNUAL. Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Seniority Level

• Executive

Employment Type

• Full‑time

Job Function

• Health Care Provider

Industries

• Hospitals and Health Care