Molina Healthcare

Chief Medical Officer, Health Plan (Based in IL)

Molina Healthcare$200K — $250K *
Healthcare
11 - 15 years of experience
Job Overview by Ladders

Qualifications

  • 12+ years healthcare leadership experience, including clinical practice and managed care as a medical director.
  • 7+ years healthcare management experience.
  • Active and unrestricted MD or DO license in the state of practice.
  • Board certification required.
  • Knowledge of healthcare laws and regulations affecting clinical staff.
  • Strong leadership, communication, and financial skills.
  • Demonstrated strategic decision-making ability.

Responsibilities

  • Provide executive vision and strategy for medical affairs functions.
  • Lead analysis of medical care cost and utilization data.
  • Direct and oversee medical management staff to achieve performance metrics.
  • Promote initiatives for optimizing utilization of medical resources.
  • Ensure medical management decisions maximize member benefits and align with corporate goals.

Benefits

  • Comprehensive benefits package including healthcare and retirement options.
  • Opportunities for professional development and certifications.
  • Supportive corporate culture focused on quality and efficiency.
Full Job Description
Job Description

JOB DESCRIPTION Job Summary
Provides executive level strategy and leadership to the health plan in the development and execution of care management and utilization management programs. Develops clinical practice guidelines and oversees appropriateness and medical necessity of services provided to plan members - targeting improvements in efficiency and satisfaction for members and providers. Partners with executive leadership team to provide cohesive direction towards company goals. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care.

Essential Job Duties
• Provides executive strategy, vision and direction to the health plan for the medical affairs function. Provides strategic support for design/implementation/execution for programs related to quality improvement, utilization management, care management, predictive modeling and disease management. Responsible for performance and financial results of medical affairs function, and keeps executive leadership apprised.
• Leads the health plan's analysis of medical care cost and utilization data. Leads and manages the development of techniques to effectively correct identified and anticipated utilization problems while assuring that members receive the care they need.
• Provides leadership, direction and oversight functions to the health plan's medical management staff to achieve best in class performance as defined by identified metrics.
• Demonstrates a positive leadership role in key health plan medical management initiatives aimed at optimizing utilization of medical resources.
• Oversees and directs the rendering of medical management decisions at all levels of the health plan that maximize benefits for members while pursuing and supporting corporate objectives.

Required Qualifications
• At least 12 years of relevant health care leadership experience, including clinical practice experience, and at least 2 years as a medical director in managed care organization supporting utilization management/quality program management, or equivalent combination of relevant education and experience.
• At least 7 years health care management/leadership experience.
• Active and unrestricted Doctor of Medicine (MD) or Doctor of Osteopathy (DO). License must be active and unrestricted in state of practice.
• Board certification.
• Working knowledge of applicable national, state, and local laws and regulatory requirements affecting medical and clinical staff.
• Experience demonstrating strong leadership and communication skills, consensus building, collaborative ability and financial acumen.
• Demonstrated ability to make strategic decisions.
• Excellent verbal and written communication skills.
• Microsoft Office proficiency.

Preferred Qualifications
• Certified Professional in Healthcare Management (CPHM), Certified Professional in Healthcare Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of America (CMSA) certification, or other health care or management certification.
• Prior experience with process improvement activities, policy and procedure development, and operational efficiency.

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package.

About Molina Healthcare

Molina Healthcare focuses exclusively on government-sponsored health care programs for families and individuals who qualify for government-sponsored health care. It contracts with state governments and serves as a health plan, providing a wide range of quality health care services to families and individuals.

Molina Healthcare Careers

Join the dedicated team at Molina Healthcare, a leader in providing quality healthcare services to families and individuals who qualify for government-sponsored programs, including Medicaid and Medicare. As one of the most respected companies in the health services industry, Molina Healthcare offers unparalleled job opportunities aimed at empowering your career growth and professional development.

Work You’ll Do

At Molina Healthcare, you will engage in meaningful work that directly impacts lives across the country. Our team is committed to innovation in healthcare, ensuring that all members receive the best care possible. By joining us, you will collaborate with skilled professionals dedicated to our mission of providing accessible, high-quality healthcare.

Career Opportunities and Growth

Whether you are looking for your first job, seeking a leadership role, or aiming to specialize in healthcare professions, Molina Healthcare offers a range of career paths. Our job opportunities span across various functions, including clinical services, customer support, IT, project management, and more. We believe in fostering the growth of our employees through professional development, leadership training, and diversity initiatives.

Internship Programs

Kickstart your career with a Molina Healthcare internship. Our internships provide invaluable workplace experience, offering a glimpse into the healthcare industry through hands-on projects and mentorship. Interns at Molina Healthcare gain critical skills that prepare them for future employment, making them competitive candidates in the job market.

Culture and Benefits

Molina Healthcare is not just a company; it’s a community. We prioritize a culture of inclusivity and respect, where all team members are encouraged to bring their whole selves to work. Our employees enjoy comprehensive benefits, including health insurance, retirement plans, and wellness programs, all designed to support both their professional and personal lives.

Join Our Team

Explore the various positions available at Molina Healthcare and find where your skills and interests align with our needs. We are continuously hiring talented individuals who are passionate about making a difference in healthcare. Prepare your resume, sharpen your interview skills, and become part of a team that values hard work and creativity.

Stay Connected

Keep up to date with the latest at Molina Healthcare: - **Career Growth and Networking:** Advance your career through our professional development and networking opportunities. Learn from leaders and peers alike to build connections that propel your career forward. - **Innovation and Leadership:** Drive change and lead with confidence by participating in our leadership and innovation training programs.

Apply Now

Ready to take the next step in your healthcare career? Search open positions that match your skills and interests on the Molina Healthcare Jobs portal. We look for driven, curious, and compassionate team players ready to make an impact.

Stay Informed

Subscribe to Molina Healthcare job alerts and receive updates on new openings and company news directly to your inbox. Tailor your subscription to match your career preferences and stay ahead in the dynamic field of healthcare. Join Molina Healthcare, where your career is nurtured, your contributions are valued, and your growth is guaranteed.
Learn more about Molina Healthcare
Size
14,000 employees
Market Cap
$19.5 billion
Industry
Net Income
$673 million
Founded
1980
5 Year Trend
+9.3%
Revenue
$19.4 billion
NASDAQ

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