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Chief Medical Officer - Valley Health Plan

Salary: $283,391.03 - $353,664.44 Annually
Location : Throughout the County of Santa Clara, CA
Job Type: Full-Time
Department: Valley Health Plan
Closing: Continuous

Valley Health Plan (VHP), a Knox-Keene licensed County operated health plan located in the heart of Silicon Valley, serving 160,000 members is seeking a Chief Medical Officer (CMO) who will support VHP's mission to address the holistic needs of the members served and will be actively involved in the shift toward a value-based, integrated delivery system in collaboration with strategic partners to ensure the delivery of the highest value medical, pharmaceutical, behavioral and social services and supports. VHP's CMO has overall accountability and oversight of all clinical functions and medical cost trends consistent with the vision and strategy set forth by VHP's senior executive leadership team.

Establishes credibility and rapport with senior executives, clinicians and community leaders and representatives. Participates and supports the communication, education, and maintenance of partnerships with contracted providers and physician groups. Serves as the interface between VHP and accrediting bodies and regulators on clinical matters.

Manages, mentors, and coaches a high performing team that is focused on clinical quality, service excellence and population health. Rallies support for the overall VHP vision and provides clinical strategies and plans to ensure delivery of the highest value clinical and service outcomes to the communities served by VHP. Responsible for the financial health of VHP related to medical cost and utilization trends.

Collaborates with clinical leadership and key stakeholders to oversee the development and implementation of an effective care management infrastructure, including clinical practice improvement to reduce variation and improve efficiencies. Actively supports Compliance and Operations to ensure VHP meets and exceeds medical management, quality, accreditation and regulatory standards. Accountable for ongoing monitoring, measurement, and communication of medical management programs, technology and processes (e.g. utilization management, care management, etc.). Oversees the analysis of overall medical expense and performance data, including HEDIS.

Uses population health and value-based care management in the development and evaluation of systems that fully integrate care and value-based reimbursement across the continuum of health care delivery. Accountable for adoption of evidence-based medical guidelines and protocols with proper stewardship of resources analyzing members and population data to guide clinical program direction. Oversees the administration of medical management programs to assure that network providers deliver, and members receive appropriate, high quality, and cost effective care.

Leads in a way that aligns to the mission, vision, and values of VHP and the County.

Click here to learn more about this position:[0]=Executive%20Management%20&sort=PositionTitle%7CAscending&pagetype=jobOpportunitiesJobs

This recruitment will continuously accept applications until position is filled.

The recruitment may be extended or closed as early as 10 days after issue date, therefore, it is critical to submit your application as soon as possible. This recruitment requires the submission of an online application. No paper applications will be accepted. Applicants who are viewing this job announcement outside of our Santa Clara County website must go to to apply.

It is important that the following information be included in your application as it will be evaluated during the competitive review step of the recruitment process:

1. Résumé
2. Contact information for a minimum of three references
3. Letter of interest explaining why you are the ideal candidate, including specific examples from your experience. No more than 3 pages.
4. Answers to the online supplemental questions

Questions regarding this Executive recruitment may be directed to Adrian Cudal, Executive Services at (408) 299-5852.


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Typical Tasks:
Stays abreast of emerging models of value-based healthcare delivery. Identifies and defines new and innovative clinical strategies to support VHP's goals and objectives.

Develops programs that drive clinical integration, quality and fiscal and service performance.
Provides medical expertise to all VHP's operating units, including Provider Contracts Administration, Credentialing, Concurrent in-patient admission review, Prior-authorizations, Claims, Marketing and Sales, etc..
Ensures the integrity of VHP's clinical processes and provides leadership to the quality management and improvement program.
Participates in the design and implementation of value-based delivery models and ensure that the technology and analytic infrastructure is implemented to demonstrate achievement of expected performance outcomes. Establishes and implements practice guidelines, policies and protocols compliant with regulatory and accreditation requirements. Designs and implements the clinical oversight program.
Participates or chairs clinical committees as designated.
Leads the design and implementation of programs and practices to identify opportunities for improvement of quality outcomes and medical cost improvement initiatives.

Employment Standards
A board certified MD or DO with an active, unrestricted California medical license with at least five years of clinical practice and five years of experience in an executive role in a health plan. An MBA, MPH or MHA and experience in a Knox-Keene licensed health plan is preferred, although not required.

Knowledge of:

Clinical operations
Utilization Management
Care Management
Population Health
Clinical Quality Management
Pharmacy Benefit Management
Population Health
Performance Improvement
Value-based reimbursement models
Industry standard clinical guidelines and protocols
Process mapping
Project management

Ability to:
Provide leadership and oversight of managed care principals across the continuum of care, ensuring the provision of care and allocation of resources designed to achieve cost and quality objectives, regulatory compliance and the improvement of the patient experience.
Oversee the selection and implementation of technology solutions to support the performance and improvement.
Proficiency working in a managed care environment with a philosophy of collaboration and teamwork.
Develop programs that drive clinical integration.
Communicate effectively with a culturally and socially diverse patient population, physicians, and the public.
Provide direction and leadership to implement changes that will result in revenue and market share enhancement.
Lead the evaluation of VHP's clinical performance and recommend changes.
Serve as VHP's clinical expert to the external community relative to VHP's clinical strategy, policies, programs, and delivery model.
Guide and direct the medical leadership team including recruiting, coaching, and development of team members; develop a leadership and management succession plan; actively lead and support a positive proactive, results-orientated culture that demonstrates VHP's mission, vision, and values.
Excellent verbal and written communication skills with the ability to build consensus.

Time:  Full time
Salary:  Salary
Category:  Administration

Updated: 11/27/2019 4:43:37 PM

Job Contact:
Recruitment VHP

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