Job Description

Opportunity Summary

Reporting directly to the Chief Executive Officer, the Chief Medical Officer (CMO) provides clinical oversight and expertise internally for both the Clinic and Health Plan. Medical Associates is Iowa's oldest physician-owned multi-specialty group practice, delivering care across 33 specialties in 10 Iowa-Illinois-Wisconsin locations.

Medical Associates Health Plans was established in 1982, the Tri-State area’s first health maintenance organization. As the clinical leader of the health plan, this person will expand care management programs and lead activities partnering with physician leaders to improve clinical efficiencies and outcomes using disease management, population management, and evidence-based care programs.

As a member of a five-person executive team leading strategic direction, the CMO is instrumental in advocating for the patient as well as providing clinical oversight, advocacy and support among fellow physicians. Additionally, the CMO is responsible for leading the organization's ongoing readiness and response to changing rules and regulations.

This individual will assist its fellow administrative leaders and physician shareholders in driving innovation and merging the highest standard of care with efficient business practices.

Education

• Doctor of Medicine (M.D.) or Doctor of Osteopathic Medicine (D.O.) is required
• Master’s in Business Administration (MBA) or Healthcare Administration (MHA) strongly preferred

Experience & Qualifications

• Board Certified practicing physician, willing to obtain Iowa licensure if not currently held.
• A minimum of 10 years of clinical practice.
• Population Healthcare experience required, specifically in supporting and/or planning, implementing and evaluating population health programs.
• Demonstrated successful program development, change management, relationship building, and staff development in prior leadership roles.
• Solid understanding of the inner workings of medical management activities, including case management, utilization management, quality management, and prior authorization.
• Experience building external relationships with physicians developing clinical programs around disease management or population health management helpful.

Reporting Relationship

The Chief Medical Officer reports to the President and Chief Executive Officer.

Duties & Responsibilities 

• As a key member and representative of the Medical Associates executive leadership team, foster the kind of collaboration and innovative thinking necessary to promote care delivery redesign and payment reform, and ensure better quality, greater efficiency, and higher levels of patient satisfaction across the care delivery system.
• Provide medical direction, management, and oversight of the Quality Improvement Utilization and Case/Disease Management Programs. Responsible for oversight and reporting to corporate governance on NCQA-required activities.
• Lead the development and implementation of the strategic plans and objectives for improving quality and reducing unnecessary medical costs. Provide analysis and recommendations to the executive leadership team and board of directors regarding trends in clinical quality and medical costs, and help establish benchmarks and targets. Counsel the CEO on matters of policy, strategy, and leadership to achieve overall objectives.
• Provide clinical leadership for the ongoing development, implementation, and management of information systems and data analysis for quality and utilization and clinical performance measurement, ensuring the continued high-level offerings of the medical informatics platforms.
• Provide ongoing leadership and support for the maintenance and continued development of a full range of medical informatics services, including: clinical quality and medical cost key indicator reports; provider performance profiling studies and reports; clinical outcome measurements; populations health management database and additional programs, tools, and analytic services as required for improving medical decision making; and monitoring and improving the health of the plan’s members.
• Coordinate, influence, and assist in directing the physicians to achieve the clinical management goals of the system, inclusive of medical policy, clinical goal setting, interpretation of performance data, and understanding/operationalizing new initiatives.
• Develop and foster strong working relationships and communication at all levels to ensure timely implementation of new strategies and coordinate implementation of corrective strategies to resolve problems or situations that may arise. Problem-solve issues that are barriers to expected results.
• Represent Medical Associates’ interests on clinical and operational issues to various external constituencies, including but not limited to CMS and other governmental agencies, medical and hospital communities, and various advocacy organizations. Provide leadership in building community partnerships, joint ventures, and new market outreach.
• Provide leadership in defining care coordination (disease management/case management) operations, including outcomes measurement. Ensure establishment and provide oversight of a methodology for continuous analysis and improvement of all care management activities.
• Collaborate with and actively support the plan’s sales and marketing activities, including participation and presentation of the Medical Associates’ quality/value proposition.
• Primary responsibility for and direction of healthcare cost management activities, including direction and support for the following health services functions: nurses in prior authorization, concurrent and retrospective review, referral coordination, and case management activities.
• Coordinate administrative functions for provider staff to include leading and successfully achieving results in clinical quality, patient satisfaction, finance (including profitability and growth), safety, and engagement. Monitor and manage provider performance, including productivity, practice efficiency enhancements, clinical quality, patient safety, patient experience, and total cost of care. Hold providers and other caregivers accountable to performance expectations and goals. Assist in the recruitment, orientation and retention of Medical Associates physicians, associate staff, and advanced practitioners.

Knowledge, Skills and Abilities 

The successful candidate will possess a wide range of needed personality traits, work habits, and social skills necessary to perform effectively within the organization. This individual will possess both personal and professional integrity, strong communication skills, and a professional appearance and presentation.

Specifically, the following knowledge, skills, and abilities are required to be successful in this position:

• Open leadership style. Actively seeks out and supports collaborative thinking and problem solving with others in the organization.
• Honest and a highly ethical team player.
• Strong people management and leadership skills. Ability to communicate and work well with people at all levels.
• Highly engaged, energetic, focused, and execution-oriented.
• Strategic vision combined with strong operational capabilities; ability to position the organization for the future, looking beyond the present situation to conceptualize key trends and identify changing market demands while also being able to drive and implement initiatives that move the organization forward.
• An extremely organized, disciplined, hands-on, and process-oriented leader who is not afraid of digging into details when necessary.
• Initiative, self-confidence, good judgment, and the ability to make decisions in a timely fashion.
• Strong work ethic; achievement-oriented; motivated beyond personal interests.
• Problem-solves and approaches work from a “return on investment” perspective.
• Knowledgeable of how decisions impact all aspects of the business. Approaches his/her work as an interconnected system. Ability to understand major objectives and break them down into meaningful action steps.

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