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The Market CMO is an instrumental clinical leader of our primary care team, combining clinical practice experience with leadership and operational management to ensure high-quality patient care and alignment with Value-Based Care (VBC) principles. This market specific role requires flexibility to adapt responsibilities as needed and demands a unique blend of clinical management, financial/business acumen, and strategic partnership to optimize patient care and business outcomes.
Job Description
KEY RESPONSIBILITIES
Leadership & Organizational Management:
Understand organizational & market priorities, trends, and goals, to develop a clinical strategy to advance clinical talent and performance
Identify physician recruitment needs and collaborate in the hiring and contracting of providers.
Plan, organize, manage, and supervise the roles of the Center Medical Directors.?
Build strong relationships with specialists, hospitalist, SNF and other providers to form a narrow network of quality service focused on senior population health.
Responsible for medical interpretation, reviews, and decisions as required for plan administration.
Monitor medical performance and provide guidance to ensure that the quality of care being provided meets appropriate standards and to ensure cost-effective utilization practices.
Represent CenterWell/Conviva brands in local communities and related media activities while collaborating with the recruitment team to build and network a pipeline of high-quality primary care clinicians (physicians, APPs, MAs, and other clinical professionals)
Clinical/Patient Management:
Foster a robust patient-centered and value-based clinical vision, strategy, and culture locally that orients care teams around excellence in patient care, teamwork, outcomes
Deliver leading clinical performance in patient experience, quality of care, clinical outcomes, and avoidable utilization
Periodically review clinician charts to identify opportunities in care, ensuring clinical assessments are accurate and that performance improvement and coaching initiatives are precise ?
Identify critical issues for high-risk patients during case reviews & other forums, and modeling and driving clinical excellence
Conduct root cause analysis of care opportunities from both individual, team, and systems perspectives and partner with clinical and operational colleagues to improve high-reliability care as a team
Ensure clinicians effectively co-manage high risk episodes of care and patients with partnered Care Integration Team (CIT) resources and programs for transitions of care management (TCM), high-risk patient management (HRPM), and social determinants of health (SDOH) efforts, improving clinical outcomes and avoidable utilization
Monitor and manage daily patient care and initiatives to improve team-based key performance indicators (KPIs), such patient experience via Net Promoter Score (NPS) and Medicare clinical quality via HEDIS, meeting local and organizational goals
Personally deliver high-quality primary care and demonstrating a high degree of patient care ownership and clinical excellence in age-friendly senior primary care including health promotion & prevention, disease management, effective specialist & hospital co-management, and complex care management
Spend 20-30% of time on direct patient care, with remaining time dedicated to administrative responsibilities. The percentage of time may vary by market needs and by staffing levels throughout the year.
Dyad Partnership:
Collaborate with operational leaders (Market President) and Shared Services partners to align on clinical and operational goals, strategic planning, and budgeting
Maintain regular communication to align on performance, strategies, and team communication and management, ensuring unified decision-making and consistent messaging for cohesive leadership.
Work together towards common goals that support the mission, vision, values, and overall patient experience outcomes, managing clinic/market dynamics and engagement.
Partner on strategic and operational insights, including capital and operational budgeting, and monitor clinical & financial performance and metrics.
Review clinician schedules and incentive plans to align with patient care access and management goals.
Use your skills to make an impact
Required Qualifications
Master's Degree
8 or more years of technical experience
5 or more years of management experience
Licensure requirements of the state of jurisdiction
Graduate of accredited MD or DO program of accredited university
Prefer Internal Medicine specialty
Board Certification in Family Medicine, Internal Medicine or Geriatric Medicine
This role is considered patient facing and is part of Humana/Senior Bridge's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Preferred Qualifications
Knowledge of Medicaid and Medicare programs
Excellent oral and written communication skills
Good understanding of best practice coding and documentation in value-based environment
Additional Information
Leveraging Technology: You are technological savvy and know how to appropriately share and use your knowledge to improve business results.
Problem Solving: You are a problem solver with the ability to encourage others in collaborative problem solving. Acting as both a broker and consultant regarding resources, you engage others in problem solving without taking over.
Accountable: You meet clearly stated expectations and take responsibility for achieving results.
Clinical Knowledge: You understand clinical program design, implementation, management/monitoring to support choice in consumer medical care. Understands the medical utilization implications of such programs
Communication: You actively listen to others to understand their perspective and ensure continuous understanding regardless of communication channel or audience.
LI-KD2
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$270,800 - $378,800 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About Us
About CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. Our unique care model focuses on personalized experiences, taking time to listen, learn and address the factors that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more time with patients, providing compassionate, personalized care that brings better health outcomes. We go beyond physical health by also addressing other factors that can impact a patient's well-being.
About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.
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Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Centerwell, a wholly owned subsidiary of Humana, complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our full accessibility rights information and language options https://www.partnersinprimarycare.com/accessibility-resources
