Job Description
Are you a passionate and experienced physician leader with a focus on behavioral health? Do you thrive in a collaborative environment where you can truly impact patient care? We're seeking a dynamic Senior Medical Director (CMO) to lead our behavioral health initiatives in New Mexico. This is a unique opportunity to shape the future of mental healthcare and make a lasting difference in the lives of individuals and families.
About the Role:
As the Senior Medical Director (CMO) for our health plan in New Mexico, you will be the clinical visionary, responsible for developing and implementing programs that support our mission of providing high-quality, cost-effective care. You'll oversee all aspects of clinical operations, from utilization management and care coordination to population health and quality improvement. Your leadership will be essential in ensuring we meet and exceed NCQA and URAC standards, while also championing parity efforts. This role offers a blend of strategic leadership, clinical expertise, and community engagement.
Compensation and Benefits:
We offer a competitive salary range of $222,380 - $422,520 annually, commensurate with experience and qualifications. In addition to a competitive salary, you will be eligible for short-term incentives and a comprehensive benefits package. Our benefits are designed to support your physical, mental, emotional, and financial well-being, and include a wide range of health, life, and voluntary options.
What You'll Do:
Provide clinical leadership to the interdisciplinary Medical Management team, including oversight, consultation, and training.
Ensure the quality of utilization review determinations, including appeals.
Conduct medical necessity reviews and peer-to-peer reviews.
Monitor case management and disease management programs to ensure clinical goals are met.
Participate in case rounds and develop case management plans.
Evaluate the effectiveness and cost of clinical programs using data analysis.
Engage with external stakeholders, including health plan partners, state agencies, and regulators.
Lead Quality Improvement (QI) programs, ensuring effectiveness and compliance.
Participate in network credentialing and quality improvement committees.
Recruit, train, supervise, mentor, and evaluate medical staff and physician advisors.
Develop and manage medical director budgets.
Develop and implement the Medical Action Plan (MAP) to address cost of care.
Implement national and local medical policies and procedures.
Assess technology and clinical practice standards.
Monitor the quality and quantity of clinical reviews and care plans.
Collaborate with the network management team on integrated clinical-network approaches.
Provide after-hours coverage as required.
Participate in RFP response development.
What You'll Bring:
Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) degree or equivalent international degree with required US training.
Graduate of an accredited American or Canadian medical school.
Completion of a US or Canadian residency program approved by the ACGME.
At least 7 years of post-residency experience with substantial direct patient care.
Clinical experience relevant to the patient population.
Unrestricted medical license in New Mexico.
Strong leadership skills and ability to drive change.
Experience with cost-benefit analysis, medical decision analysis, credentialing, quality assurance, and CQI processes.
Targeted specialties: Psychiatry, Psychiatric sub-specialty, Primary Care, Geriatrics, Palliative Care, or Physical Medicine.
Location:
This is a remote position based in New Mexico. Candidates must reside and be licensed in NM.
Employment Type: Full-Time
Salary: $ 222,380.00 Per Year
Job Tags
Full time, Temporary work, Local area, Remote work,