Behavioral Health Senior Medical Director (CMO) - Remote New Mexico

Job Overview

We are looking for a dedicated and experienced physician leader with a specialization in behavioral health to step into the role of Senior Medical Director, serving as our Chief Medical Officer for our health plan in New Mexico. This remote position presents an exceptional chance to influence the landscape of healthcare delivery, enhance patient outcomes, and lead a passionate team of professionals.

Key Responsibilities

• Provide clinical leadership and oversight for all aspects of the health plan's clinical operations, encompassing service coordination, utilization management, care/case management, population health/disease management, and quality improvement.
• Spearhead parity initiatives while ensuring adherence to medical policies, clinical guidelines, and operational standards.
• Analyze utilization, quality, and financial data to foster improvements in care delivery.
• Mentor and guide Medical Directors and Physician Advisors, building a robust leadership pipeline.
• Cultivate and maintain strong relationships with providers, health plan partners, members, and state agencies.
• Act as a representative of the organization in community engagements and with key stakeholders.
• Provide clinical direction to the interdisciplinary Medical Management team, supervising clinical team members and consulting with care managers.
• Ensure the quality of utilization review determinations and oversee case management and disease management initiatives.
• Evaluate the effectiveness and cost of clinical programs and participate in case rounds to develop comprehensive care management plans.
• Interface with external stakeholders, including health plan and state government partners, to enhance service delivery.
• Contribute medical leadership for Quality Improvement (QI) Programs and engage in network credentialing and quality improvement committees.
• Recruit, train, supervise, mentor, and evaluate medical staff and physician advisors.
• Develop and manage operational budgets, implement Medical Action Plans (MAPs), and assess technology and clinical practice standards.
  
  

Required Skills

• Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) degree or equivalent international qualification.
• Unrestricted, current, and valid medical license in New Mexico.
• Board certification (ABMS or Specialty Board).
• At least seven years of post-residency experience with a substantial focus on direct patient care.
• Proven leadership skills with a demonstrated ability to drive organizational change.
• Relevant clinical experience tailored to patient populations under management.
• Proficient in cost-benefit analysis, medical decision analysis, credentialing, quality assurance, and continuous quality improvement.
  
  

Qualifications

• Completion of a US-based internship and residency (and fellowship for subspecialists) is required.
• Targeted specialties include Psychiatry, Psychiatric sub-specialty, Primary Care, Geriatrics, Palliative Care, or Physical Medicine.
  
  

Career Growth Opportunities

This pivotal role offers significant prospects for career advancement, enabling you to shape and implement clinical strategies across diverse business lines, including Medicaid, Medicare, and Commercial.

Company Culture And Values

Join an organization that values collaboration and innovation, where professionals work together to elevate healthcare delivery. Our focus is on making a significant impact in the lives of our members, fostering a culture of integrity and respect.

Compensation And Benefits

• We provide a competitive salary package commensurate with your skills, experience, and educational background.
• A comprehensive benefits package is available, designed to support your overall well-being, including health, life, and other voluntary benefits.
  
  

Employment Type: Full-Time