Iowa City, Iowa
Iowa City, Iowa
Towson, Maryland
Shrewsbury, Massachusetts
San Jose, California
Ann Arbor, Michigan
Posted: 30-Sep-24
Location: Los Angeles, California
Salary: Open
Categories:
Internal Number: 143007999
Take on a key clinical leadership role within a dynamic health organization. Help drive the delivery of high-quality, cost-effective care for Medicare Advantage members. Take your expertise to new levels. You can do all this and more at New Century Health Plan.
Reporting to the Chief Medical Officer, you will play a pivotal role in leading clinical efforts to optimize care delivery and outcomes for Medicare Advantage members. You will:
- Provide clinical leadership and oversight to ensure the highest standards of care and cost-effectiveness
- Manage utilization and case management activities to drive efficiency and quality
- Oversee appeals, grievances, and potential quality issues (PQI)
- Develop and implement clinical strategies to improve health outcomes and ensure compliance with regulatory requirements
- Collaborate with senior leaders to enhance the overall performance of the Medicare Advantage Plan
We’re seeking a dedicated and experienced clinical leader with:
- MD or DO degree from an accredited medical school
- Board certification in a primary care specialty (Internal Medicine, Family Medicine, Geriatrics)
- Valid and unrestricted medical license in California
- Advanced degree in healthcare management or related field, highly desired
- 3 or more years of clinical practice experience
- 2 years or more years of Medicare Advantage management experience
- Experience in a health plan or large healthcare organization, preferred
- Strong knowledge of Medicare regulations and CMS guidelines
- Excellent analytical, problem-solving, and decision-making skills
- Strong communication and interpersonal abilities
- Proven leadership abilities that demonstrate openness to change and a capacity for implementing creative programs that support strategic initiatives
- Strong analytical, organizational, and project management skills
- Proficiency in Microsoft Office applications (Word, Excel, PowerPoint)
