Senior Medical Director, Aetna Better Health of Illinois

Hispanic Alliance for Career Enhancement; United States; Remote; USD 184,000 - 397,000; Full time

Job summary

A leading health solutions company is seeking an ABHIL Chief Psychiatrist to manage Behavioral Health activities and drive clinical excellence. The role requires a current IL Medical license, board certification, and experience in healthcare delivery. Competitive pay range from $184,112 to $396,550, with great benefits including medical plans and 401(k) matching.

Benefits

Affordable medical plan options

401(k) plan with matching contributions

Employee stock purchase plan

No-cost wellness screenings

Tuition assistance

Qualifications

• At least three years' experience in the health care delivery system.
• Preferred 3 years of Medicaid and managed care experience.
• Must have a current, unencumbered IL Medical license.
• Board Certification in a recognized specialty required.

Responsibilities

• Lead clinical strategy across all Behavioral Health populations.
• Review and analyze data trends to identify areas for improvement.
• Collaborate with State regulators and providers as a clinical executive.

Skills

Clinical practice

Population health management

Health care delivery system

Influencing healthcare outcomes

Education

MD or DO Required

Job description

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary:

The ABHIL Chief Psychiatrist (Senior Medical Director) will serve as a strategic and operational partner to the State, CEO, COO, Health Service Officer, and other executive team members in managing all Behavioral Health activities by driving clinical excellence, achieving measurable health outcomes, and supporting quality and medical management in a highly matrixed environment.

Accountable for overall plan results and the delivery of high-quality cost-effective products and services that strategically align to the goals of the State partner. Ensures members get the right health care treatment for their needs, working to eliminate low value care, over and underutilization of health care services in alignment with the Quintuple AIM.

Primary Job Duties & Responsibilities:

• Responsibilities specific to Behavioral Health activities across all health plan populations.
• Develop, implement, support, and promote state clinical programs, population health strategies, tactics, policies, and programs that drive the delivery of high value healthcare to establish a sustainable competitive business advantage by supporting the plan goals.
• Review, interpret and analyze data and trends at State level in: UM, CM, Pop Health, LTSS and Health Equity in order to identify risks and opportunities for improvement.
• Serve as clinical executive leader for State regulators, providers, and other key partners. Serve as clinical leader for provider engagement and enablement.

Fundamental Components & Physical Requirements:

The ABHIL Chief Psychiatrist is a member of the plan executive leadership team and must collaborate cross functionally to achieve plan goals specific to the Behavioral Health program including:

• Leads clinical strategy across all HFS pillars and HealthChoice Illinois populations.
• Develops and continuously updates an overall transformation strategy and set of key tactics for remediating those gaps, including critical success factors, metrics, and targets.
• Provide direction, support and medical expertise and oversight to all areas within the clinical services including Care Management, Utilization Management, Population Health, Health Equity and Quality programs supporting state pillars for Behavioral Health aligned with the state contract.

Required Qualifications:

• At least three years' experience in the health care delivery system e.g., clinical practice and health care industry.
• Preferred 3 years of experience Medicaid and managed care experience.
• Must be a resident of Illinois and a physician and with a current, unencumbered IL Medical license.
• Board Certification in a recognized specialty including post-graduate direct patient care experience.

Preferred Qualifications:

• Demonstrated experience in population health management and managed Care.
• Passion and ability to influence and drive better outcomes in healthcare delivery.
• Understanding of Value Based Contracting/Accountable Care and how this relates to improving the quality of care for our members through collaboration with the provider community.

Education:

MD or DO Required Board Certification required in an ABMS or AOA recognized specialty.

Pay Range

The typical pay range for this role is: $184,112.00 - $396,550.00

This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Great benefits for great people

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.