Deputy Chief Medical Officer
Job Ref: 44784
Category: Utilization Review and Case Management
Department: CLINICAL SERVICES ADMIN.
Location: New York, NY
Job Type: Regular
Employment Type: Full-Time
Hire In Rate: $315,000.00
Salary Range: $315,000.00 - $330,000.00
MetroPlus Health Plan provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlus’ network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlus has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.
Reporting to the Chief Medical Officer, the Deputy Chief Medical Officer helps to play a critical role in managing the health plan’s medical quality, cost, and assuring appropriate health care delivery. The Deputy Chief Medical Officer serves in policy, operational and strategic capacities and helps lead health informatics function build and operation. The Deputy Chief Medical Officer’s overall purpose is to work across medical management functions focusing on Utilization Management, Case Management, Quality assurance, HIV, MLTC, pharmacy, health informatics and BH departments. This is a broad function that includes day to day operations, data and reporting design and high level strategy, planning and policy involvement.
Scope of Role & Responsibilities
- Enhances the health informatics function and assures decisions are made according to data insights.
- Leads new projects and initiatives.
- Assists in new technology assessment and clinical policy review as required
- Responsible for overseeing implementation of ongoing changes in policy and procedures from State and Government entities.
- Participates in the development of strategic planning for existing and expanding business.
- Represents the health plan at regulatory meetings held by the New York State Department of Health, the New York City Department of Health and Mental Hygiene and managed care trade organizational meetings as necessary.
- Develops VBP strategies
- Fosters relationships with the Delivery System
- Reviews cases, determines medical necessity, and consults with physicians.
- Provides clinical support for Member and Provider appeals.
- Performs other duties as needed and assigned by the Chief Medical Officer
- Doctor of Medicine or Doctor of Osteopathic Medicine degree from an accredited and approved school of medicine.
- A minimum of three (3) years of clinical experience post residency
- A minimum of seven (7) years of experience in a Managed Care setting.
- Proven experience with heath informatics/data sciences
- Minimum five (5) years of management experience
Licensure and/or Certification Required
- Valid and current license to practice medicine in the state of New York.
- Board Certification
- Integrity and Trust
- Problem solver
- Customer Focus
- Functional/Technical Skills
- Written/Oral Communications
How To Apply
If you wish to apply for this position, please apply online by clicking the "Apply Now" button or forward your resume, noting the above Job ID #, to:
MetroPlus Health Plan
Human Resources Department
160 Water Street 8th Floor
New York, NY 10038
Attn: Recruitment Unit