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

Job Overview

We are in search of a visionary and dedicated Senior Medical Director to spearhead our behavioral health initiatives in New Mexico. This remote role offers a unique opportunity to influence the future of behavioral healthcare while making a significant difference in the lives of individuals and families.

Key Responsibilities

• Provide clinical leadership and strategic direction for our behavioral health programs across various lines of business, including Medicaid, Medicare, and Commercial.
• Oversee service coordination, utilization management, care/case management, population health, and quality improvement initiatives.
• Drive the implementation and management of programs that align with our clinical vision, ensuring cost-effective and high-quality care.
• Advocate for parity in behavioral health services, ensuring all necessary documentation is maintained.
• Establish compliance with medical policies, clinical guidelines, and quality standards, maintaining NCQA and/or URAC accreditation.
• Utilize data to assess utilization, quality, and financial performance, fostering a culture of continuous improvement.
• Supervise, mentor, and guide Medical Directors and Physician Advisors in their professional development.
• Cultivate relationships with healthcare providers, health plan partners, members, and state agencies to uphold our commitment to clinical excellence.
• Effectively communicate with stakeholders, presenting insights and participating in strategic meetings.
• Lead an interdisciplinary Medical Management team, providing necessary guidance and training.
• Make informed decisions regarding medical necessity and peer-to-peer reviews.
• Monitor the effectiveness of case management and disease management programs, contributing to case rounds and planning.
• Collaborate with external partners, including health plan and state government representatives, addressing emerging issues and strategic planning.
• Oversee Quality Improvement initiatives to ensure compliance and effectiveness.
• Participate actively in credentialing and quality improvement committees.
• Recruit, train, and develop medical staff and physician advisors.
• Efficiently manage budgets related to medical resources, travel, and continuing medical education.
• Develop and implement Medical Action Plans to optimize cost of care and achieve organizational goals.
• Contribute to medical policy formulation and participate in relevant committees.
• Ensure consistent standards by assessing technology and clinical practice standards.
• Monitor the quality and volume of clinical reviews and care plans.
• Work alongside network management to implement integrated clinical-network approaches, including provider visits and meeting attendance.
• Participate in after-hours coverage as required.
  
  

Required Skills

• MD or DO degree, or an international MBBS degree with necessary US training.
• Completion of a US or Canadian residency program.
• A minimum of 7 years of post-residency experience with direct patient care.
• Clinical expertise relevant to the managed patient populations.
• An active and unrestricted medical license in New Mexico.
• Board certification from ABMS or a recognized Specialty Board.
• Proven leadership and change management capabilities.
• Experience with cost-benefit analysis, medical decision analysis, credentialing, quality assurance, and continuous quality improvement.
• Relevant specialties include Psychiatry, Psychiatric sub-specialty, Primary Care, Geriatrics, Palliative Care, or Physical Medicine.
  
  

Career Growth Opportunities

This role provides a pathway for professional advancement through mentorship, leadership development, and collaboration with a network of healthcare professionals. You will play a crucial role in shaping the behavioral healthcare landscape in New Mexico.

Company Culture And Values

We are committed to fostering a supportive and collaborative work environment that prioritizes quality care and innovation. Our advocacy for parity in behavioral health services and adherence to industry compliance sets us apart as a leader in the field.

Compensation And Benefits

• Competitive salary range: \(222,380 - \)422,520 annually, commensurate with skills, experience, and location.
• Comprehensive benefits package, including health, life, and voluntary benefits.
• Opportunities for short-term incentives.
• A chance to make a meaningful difference in the lives of individuals and families.
  
  

Join our team and be a part of our mission to transform behavioral healthcare. We are proud to be an Equal Opportunity Employer and maintain a tobacco-free workplace, valuing diversity in all aspects.

Employment Type: Full-Time