WNS

CMO

WNS

full-time

Posted on:

Location Type: Remote

Location: Remote • 🇺🇸 United States

Visit company website
AI Apply
Apply

Salary

💰 $380,000 - $425,000 per year

Job Level

SeniorLead

About the role

  • Represents and serves as the clinical face of HealthHelp (HH) to health plan clients and providers, prospective clients, associations, Medical Directors, Consult Physicians, nurses, and the general public
  • Confers with board members, organization officials, and/or staff members to discuss issues, coordinate activities, and resolve problems impacting clinical operations
  • Responsible for oversight of all clinical operations entities, including medical director and physician reviewer staff
  • Oversees the HH Quality Management Program and directs its Quality Management Committee
  • Directs, plans, and implements policies, objectives, and activities for clinical programs to ensure their continuing improvement in operational efficiency and effectiveness
  • Oversees the quality of all clinical aspects and assures investors and executive management that all healthcare programs are being implemented and managed properly.
  • Carries out effective, collaborative communication with Program Management and all operations support entities in order to achieve optimal operational coordination of all clinical programs
  • Recommends changes to clinical review protocols and coordinates revisions to clinical criteria, as indicated, ensuring quality and safety for health plan client members and providers
  • Directs staff in the development of educational materials, as needed
  • Conducts educational programs and seminars, as appropriate
  • Responsible for the ongoing development and implementation of inter-rater reliability audit programs
  • Provides oversight for quality improvement projects, as needed

Requirements

  • Current, active, unrestricted license to practice medicine in a state or territory of the United States
  • Medical degree, either an M.D. or a D.O., from an accredited school of medicine
  • Board certified in one of HH’s specialties, preferred
  • Advanced degree in management, such as M.B.A., M.P.H., or M.H.A.
  • Meets HH’s credentialing requirements
  • Strategic vision of the national and international healthcare delivery marketplace
  • Seven (7) years of experience in a specialty field or medical management in a health plan
  • Three (3) years of experience developing and maintaining administrative claims data sets for the purposes of outcomes analysis and outcomes management
  • Five (5) years of experience working in a team environment and three (3) years of experience in supervisory position(s) managing direct reports
  • Three (3) years of experience managing budgets
  • Working knowledge of statistics
  • Excellent communication skills with supervisors, peers, subordinates, and clients, and ease with public speaking
  • Time management
  • Complex problem solving
  • Fluency of ideas
  • Active listening
  • Critical thinking
  • Ability to manage personnel resources
  • Ability to manage financial resources
  • Oral and written comprehension
  • Inductive and deductive reasoning
  • Ability to develop and build teams
  • Ability to develop objectives and strategies
  • Good supervisory and delegation skills – always holding direct reports accountable for the timeliness and effectiveness of their work
  • Good leadership qualities
Benefits
  • Medical, dental, and vision insurance
  • Paid time off (PTO), holidays, and sick leave
  • 401(k) with company match or other retirement plan
  • Life and AD&D Insurance
  • Employee Assistance Program

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard skills
medical degreeM.D.D.O.board certificationadministrative claims data setsoutcomes analysisbudget managementstatisticsquality improvement projectsinter-rater reliability audit programs
Soft skills
excellent communication skillstime managementcomplex problem solvingactive listeningcritical thinkingteam developmentstrategic visionsupervisory skillsdelegation skillsfluency of ideas
Certifications
active medical licenseboard certification in specialtyM.B.A.M.P.H.M.H.A.