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Chief Medical Officer - Work From Home

Company: Clevelcrossing
Location: San Juan
Posted on: September 22, 2022

Job Description:

Posted on
Jun 14, 2021 Apply for this job your email:

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The Chief Medical Officer, Group Medicare relies on the medical background to create and oversee clinical strategy for the Group Medicare business. The CMO Group Medicare, requires and in-depth understanding of how organization capabilities interrelate across segments and/or enterprise-wide.


The CMO Group Medicare will provide medical leadership and strategy for the GM business.

Work with local market utilization management and case management teams for inpatient cases.

Participate in Quality Operations including Quality Management Committee, monitor initial peer review on quality of care complaints

Participate in National, Regional and local meetings of organizations of interest to Group Medicare

Speaking engagements to provide thought leadership on behalf of Humana Group Medicare

Oversee quality improvement and HEDIS/STARS metrics to improvement with corporate and local market resources.

Provide guidance for the implementation of regional clinical programs and strategies, as well as, developing and implementing national strategies overall and for individual clients.

Attend current/future client meetings to deliver insights re: Humana clinical model of care and other programs designed to positively impact overall member health.

The CMO Group Medicare will be an integral part of the GM Leadership team and will be responsible to lead and provide thought leadership internally and externally on behalf of Group Medicare.

Assist with network development and provider contracting with various providers and ancillary providers.

Well versed on financial aspect of various levels of risk bearing contracts.

Ability to thrive in a matrix environment.

Work collaboratively with account and sales teams to deliver our superior clinical experience story to all our audiences.

Required Qualifications

A current and unrestricted license in at least one jurisdiction and willing to obtain license

Physician (MD/DO), Nurse Practitioner, Physician Assistant, Registered Nurse

Excellent communication and presentation skills

5 years of established clinical experience.

Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products.

Must be passionate about contributing to an organization focused on continuously improving consumer experiences.

Scheduled Weekly Hours

40Company infoHumana Inc.
Website :
Alternate Locations: Work from Home; US All RegionsWork Arrangement: Work from HomeRelocation assistance: : is not available for this opportunity.Pay Range: $111,500 - $241,500Bonus Potential: 20%Requisition #: 692... Alternate Locations: Work from Home; US All RegionsWork Arrangement: Work from HomeRelocation assistance: : will be considered/provided for this opportunity within our company guidelines.Pay Range: $111,500 - $241,500Bo... Job InformationHumanaAssociate VP, Research Consulting-Humana Healthcare Research (HHR).inSan JuanPuerto RicoDescriptionThe AVP requires an in-depth understanding of how organization capabilities interrelate across segments...

Keywords: Clevelcrossing, McAllen , Chief Medical Officer - Work From Home, Executive , San Juan, Texas

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