The Market CMO, Primary Care, role 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, excellence in clinical and operational processes, and strategic partnership across the Primary Care Organization (PCO) to optimize patient care and business outcomes. This role oversees and leads Associate Medical Directors (AMDs) and/or Physician Leads across multiple centers in the Louisiana/Mississippi regions. Candidates should ideally live in the region or be willing to relocate.
Responsibilities include developing and implementing clinical policies, driving quality improvement initiatives, ensuring regulatory adherence, managing medical staff, and collaborating with executive leadership to align medical services with organizational goals
Leadership & Organizational Management:
- Understand organizational & market priorities, trends, and goals, to develop a clinical strategy to advance clinical talent and performance
- Manage and actively participate in the process of interviewing, hiring, onboarding, and supervising clinical teams, including contract providers
- Develop a high-quality clinical leadership team with an emphasis on strong engagement, creating a patient-first culture, and retaining top talent
- Closely engage and communicate with market clinical leadership, clinicians, operations, and care teams. Conduct regular onsite center visits, holding regular individual 1:1s with direct reports and skip level 1:1s, clinician pod meetings, and actively participating in regular leadership meetings and clinician pod meetings
- In partnership with Market President and National Specialty team, build strong relationships with specialty providers and networks of quality service focused on senior population health
- Deeply understand, support, and improve primary care clinician performance through understanding of individual & care team context, effective use of data, real-time feedback, and effective coaching of clinical leaders, clinicians and care teams
- In collaboration with Market President, engage in regular center and market performance (clinical, financial, operational) meetings on key topics such as Medical Risk Adjustment (MRA), budgeting, staffing, operational excellence, clinical initiatives, growth and marketing
- Build strong relationships/networks to champion our senior-focused primary care strategic vision and initiatives and foster stakeholder relationships, including health plan partners, healthcare providers (e.g. specialists, hospitals), community partners, and social services, to improve our community of care locally
- May 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)
- Utilize clinical performance dashboards and data tools to support performance analysis, outcomes focus, and targeted strategy development
- Foster a culture of continuous learning and professional growth among clinical teams
- Builds the strategic framework and clinical culture that ensures proper clinician conduct and improves the overall patient experience.
- Partners and collaborates with the acquisition team, HR, and other key stakeholders throughout the merger/acquisition process, including decision making, integration and supporting post-acquisition clinical and operational procedures and processes
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
- 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
- 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
- Develop, implement and monitor the outcomes of utilization review and disease management programs to meet the quality and cost expectations.
- Identify trends of over-and under-utilization and implement actions plans to improve
- May spend 0 - 10% 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.
- Support clinical quality performance improvement in areas such as MRA, Stars, and prevention of unnecessary utilization through provider education and coaching
- Promote team-based care delivery and foster collaboration across interdisciplinary teams
Dyad Partnership:
- Collaborate with operational leaders (Associate Operations Director and/or Market President) and Shared Services partners to align on clinical and operational goals, strategic planning, and budgeting
- Maintain regular communication with operational leaders 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
- Works with dyad partner and clinical colleagues to conduct root cause analysis of care opportunities from both individual, team, and systems perspectives to improve high-reliability care as a team
- 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
- Graduate of accredited MD or DO program of accredited university
- 10 or more years of clinical experience
- 8 or more years of management experience
- Licensure requirements of the state of jurisdiction
- Prefer Internal Medicine specialty
- Active or current 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
- Skilled in use of clinical technology platforms and resources, such as EMR systems (e.g. athenahealth, Epic, eClinicalWorks), voice documentation tools (e.g. Dragon, Abridge), and clinical evidence & pathway resources (e.g. UpToDate)
- Candidates selected for this job will be required to adhere to Humana's flu vaccine policy
- Knowledge of Medicaid and Medicare programs
- Excellent oral and written communication skills
- Good understanding of best practice coding and documentation in value-based environment
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.
$335,000 - $398,000 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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
