Associate Chief Medical Officer, Managed Care - Part-Time

Applicants may apply for this position by submitting a resume/ CV to the following email address: MDRecruit@cookcountyhhs.org

When submitting a resume/CV by email, you must include the job title and posting number in the subject line of your email. An application or resume/CV must be filed for each position which interests you.

This position is exempt from Career Service under the CCH Personnel Rules.

Job Summary

The Associate Chief Medical Officer, Managed Care (ACMO, MC) will assist with oversight of all medical care and medical management utilization review activities for Cook County Health (CCH) sponsored health plan serving Medicaid recipients or any other government sponsored program, under direction of the Chief Medical Officer, Managed Care (CMO, MC). The position serves as a medical policy advisor to the health plan leadership, as well as CCH leadership, for managed care members. The incumbent provides professional leadership and direction to the utilization/cost management and clinical quality management functions. The position assists CCH leadership in monitoring and developing capacity for primary care and specialty care services reflects the needs of current and anticipated managed care members. This position establishes collaborative working relationships with other managed care functions that interface with the contracted Third-Party Administrator such as medical management, provider relations, member services, and managed care operations and administration. Assists in short- and long-range program planning, total quality management and building external relationships.

NOTE: This is a part-time role (under 20 hours/week). Compensation commensurate with education and experience. Hourly Rate: Minimum $160/hour - Maximum $175/hour.

General Administrative Responsibilities

Collective Bargaining

• Review applicable Collective Bargaining Agreements and consult with Labor Relations to generate management proposals
• Participate in collective bargaining negotiations, caucus discussions and working meetings

Discipline

• Document, recommend and effectuate discipline at all levels
• Work closely with labor relations and/or labor counsel to effectuate and enforce applicable Collective Bargaining Agreements
• Initiate, authorize and complete disciplinary action pursuant to CCH system rules, policies, procedures and provision of applicable collective bargaining agreements

Supervision

• Direct and effectuate CCH management policies and practices
• Access and proficiently navigate CCH records system to obtain and review information necessary to execute provisions of applicable collective bargaining agreements

Management

• Contribute to the management of CCH staff and CCH' systemic development and success
• Discuss and develop CCH system policies and procedures
• Consistently use independent judgment to identify operational staffing issues and needs and perform the following functions as necessary; hire, transfer, suspend, layoff, recall, promote, discharge, assign, direct or discipline employees pursuant to applicable Collective Bargaining Agreements
• Work with Labor Relations to discern past practice when necessary

Typical Duties

• Assists with overseeing clinical strategy and clinical programs for physical and behavioral health
• Acts as liaison in the absence of the CMO, MC
• Providers oversight for Utilization Management Program, Care Coordination, Long-Term Services and Support, Quality Improvement, Accreditation, Credentialing, pharmacy, Appeals and Grievances, Health Services, Behavioral Health Services, and Medical Policy.
• Responsible for ensuring managed care members receive quality, cost effective health care
• Designs and implements managed care policies, goals and objectives
• Under the direction of the CMO, plans, organizes, and directs the medical services Health Plan Services program, consisting of all primary and specialty services for in-patient, out-patient, preventive and wellness programs
• Monitors and works with providers to develop and maintain appropriate capacity for these services to meet the needs of members
• Assists the CMO, MC in providing professional leadership and direction to the functions within the medical management department (Utilization, Clinical Quality Management and Credentialing)
• Supports collaborative relationships with physicians and hospitals
• Establishes, evaluates, and modifies medical decision-making policies and review criteria, as appropriate
• Performs other duties as deemed necessary by the CMO, MC

Minimum Qualifications

• Doctor of Medicine (MD) or Doctor of Osteopathy (DO) degree from an accredited medical school or university
• Must be licensed as a physician in the State of Illinois or obtain Illinois physician licensure prior to starting employment
• Board Certification by an American Board of Medical Specialties (ABMS) in their specialty
• Five (5) years of clinical experience
• Two (2) years of leadership experience with low-income populations, including Medicaid, under and uninsured persons, dual eligible (Medicaid/Medicare)
• Prior experience with the development and implementation of clinical practice guidelines
• Knowledge of relevant regulatory and accreditation agencies and requirements

Preferred Qualifications

• Experience with Disease Management, Quality Management, and Pharmacy Management
• Certification by the American Board of Quality Assurance and Utilization Review Physicians or the American Board of Medical Management
• Master's in Public Health, MBA or MA

Knowledge, Skills, Abilities and Other Characteristics

• Must possess excellent communications skills to interface with providers, staff, and management
• Short-term and long-term planning skills
• Leadership skills
• Knowledge of Microsoft Office products (Word, Excel, PowerPoint)

Physical and Environmental Demands

This position is functioning within a healthcare environment. The incumbent is responsible for adherence to all hospital and department specific safety requirements. This includes but is not limited to the following policies and procedures: complying with Personal Protective Equipment requirements, hand washing and sanitizing practices, complying with department specific engineering and work practice controls and any other work area safety precautions as specified by hospital wide policy and departmental procedures.

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of the personnel so classified.

For purposes of the American with Disabilities Act, "Typical Duties" are essential job functions.

NOTE: This is a part-time role (under 20 hours/week). Compensation commensurate with education and experience. Hourly Rate: Minimum $160/hour - Maximum $175/hour.

BENEFITS PACKAGE

• Medical, Dental, and Vision Coverage
• Basic Term Life Insurance
• Pension Plan and Deferred Compensation Program
• Employee Assistance Program
• Paid Holidays, Vacation, and Sick Time
• You may also qualify for the Public Service Loan Forgiveness Program (PSLF)

For further information on our excellent benefits package, please click on the following link: http://www.cookcountyrisk.com/

To receive Veteran Preference, appropriate discharge papers must be attached to the online application or must be included with your emailed resume/CV. Please refer to Veteran Preference document requirements listed on the bottom of this posting.

VETERAN PREFERENCE

PLEASE READ

When applying for employment with Cook County Health, preference is given to honorably discharged Veterans who have served in the Armed Forces of the United States for not less than 6 months of continuous service

To take advantage of this preference a Veteran must:

• Meet the minimum qualifications for the position.
• Identify self as a Veteran on the employment application by answering yes to the question by answering yes to the question, "Are you a Military Veteran?"
• Attach a copy of their DD 214, DD 215 or NGB 22 (Notice of Separation at time of application filing. Please note: If you have multiple DD214s, 215s, or NGB 22S, Please submit the one with the latest date. Coast Guard must submit a certified copy of the military separation from either the Department of Transportation (Before 9/11) or the Department of Homeland Security (After 9/11). Discharge papers must list and Honorable Discharge Status. Discharge papers not listing an Honorable Discharge Status are not acceptable

OR

A copy of a valid State ID Card or Driver's License which identifies the holder of the ID as a Veteran, may also be attached to the application at time of filing.

If items are not attached, you will not be eligible for Veteran Preference

VETERANS MUST PROVIDE ORIGINAL APPLICABLE DISCHARGE PAPERS OR APPLICABLE STATE ID CARD OR DRIVER'S LICENSE AT TIME OF INTERVIEW.

MUST MEET ALL REQUIRED QUALIFICATIONS AT TIME OF APPLICATION FILING.

"Degrees awarded outside of the United States with the exception of those awarded in one of the United States' territories and Canada muse be credentialed by an approved U.S. credential evaluation service belongings to the National Association of Credential Evaluation Services (NACES) or the Association of International Credential Evaluators (AICE). Original credentialing documents must be presented at time of interview".

*Please note all offers of Employment are contingent upon the following conditions: satisfactory professional & employment references, healthcare and criminal background checks, appropriate licensure/certifications and the successful completion of a physical and pre-employment drug screen.

*CCH is strictly prohibited from conditioning, basing or knowingly prejudicing or affecting any term or aspect of County employment or hiring upon or because of any political reason or factor.

COOK COUNTY HEALTH IS AN EQUAL OPPORTUNITY EMPLOYER.