Health Plan of San Joaquin/Mountain Valley Health Plan

Medical Director

• As our Chief Medical Officer, under administrative direction, you will be responsible for leading efforts that will provide innovative solutions that support more affordable healthcare.
• Promote personal accountability for health and wellness, and offer superior service and partnerships to the constituents served by HPSJ.
• Supervises Medical Directors, Director of Pharmacy, Director of Clinical Analytics, Executive Assistant.
• Identifies, develops, plans and executes short, medium and long-range strategies that drive and support corporate objectives.
• Develops and oversees the implementation of medical management policies.
• Ensures medical decisions are rendered by qualified personnel and not influenced by fiscal considerations.
• Collaborates with the Chief Heath Services Officer on strategic planning, implementation, and oversight of Quality Improvement and Quality Management Programs.
• Manages medical utilization through application of recognized medical and pharmaceutical guidelines.
• Oversees the development and management of department budgets and accreditation activities to ensure compliance standards are met.
• Represents HPSJ in a positive manner, serving on internal and external committees and leadership forums.

Chief Medical Officer

Sales

• Responsible for promoting and selling the Health Plan Medicare Advantage products with a focus on the Dual-Eligible Special Needs Plan (D-SNP) market.
• Educate prospective members about Medicare and Medi-Cal programs.
• Ensure compliance with Centers for Medicare and Medicaid Services (CMS) and California Department of Health Care Services (DHCS) regulations.
• Drive enrollment growth within the San Joaquin, Stanislaus, Alpine and El Dorado County communities.
• Develop and execute a strategic sales plan to drive Medicare enrollments, with a strong emphasis on the D-SNP population.
• Conduct one-on-one and group sales presentations to Medicare-eligible individuals, caregivers, and community organizations.
• Build and maintain strong relationships with community partners, providers, and key stakeholders to identify and support eligible individuals.
• Attend and host community outreach events, health fairs, and informational sessions to generate leads and increase awareness.
• Maintain accurate records of sales activities, leads, and enrollments in compliance with regulatory guidelines.
• Provide exceptional customer service and follow-up to ensure high member satisfaction and retention.

Chief Medical Officer

Medicare Sales Agent