Develop, implement, support, and promote Health Services strategies, tactics, policies, and programs that drive the delivery of quality healthcare in a cost effective manner. To establish competitive business policies for NHIC / TPA through strategies, policies, and programs comprised of utilization management, quality management, network management and clinical coverage and policies.
Lead organizational growth and realignment while developing new business initiatives and executing core programs. Provide clinical leadership, advising on programmes which help address medical cost drivers & quality of performance etc.
Essential Job Functions
* Advise on medical cost drivers and data to form business conclusions and develop strategies to manage medical cost issues
* Translate broad strategies into specific objectives and action plans to implement strategies that manage business issues. Develop and maintain relationships with physician and business leadership of clients, key NHS or other health sector organisations
* The CMO has responsibility for offering advice to medical management programmes, including quality management, care management, concurrent review, discharge planning, prior authorization, behavioral health and disease management.
* The CMO is actively involved in all major clinical program components of the operation of medical management programmes.
* Provide clinical and business leadership in support of strategic business objectives.
* Manage key partnerships and alliances to maximize Healthcare Quality
* Promote quality and medical appropriateness of care.
* Leader in improving and maintaining positive relations with clients, providers, facilities, partners and consultants. Business partner in network development strategy.
* Support development of a marketable, high quality, cost effective provider network.
* Mentor relevant employees and supports ongoing training and development of staff.
* Manage relevant workforce and is responsible for all their performance management and employee development activities.
Required Skills:
Position Overview
Develop, implement, support, and promote Health Services strategies, tactics, policies, and programs that drive the delivery of quality healthcare in a cost effective manner. To establish competitive business policies for NHIC / TPA through strategies, policies, and programs comprised of utilization management, quality management, network management and clinical coverage and policies.
Lead organizational growth and realignment while developing new business initiatives and executing core programs. Provide clinical leadership, advising on programmes which help address medical cost drivers & quality of performance etc.
Essential Job Functions
Advise on medical cost drivers and data to form business conclusions and develop strategies to manage medical cost issues
Translate broad strategies into specific objectives and action plans to implement strategies that manage business issues. Develop and maintain relationships with physician and business leadership of clients, key NHS or other health sector organisations
The CMO has responsibility for offering advice to medical management programmes, including quality management, care management, concurrent review, discharge planning, prior authorization, behavioral health and disease management.
The CMO is actively involved in all major clinical program components of the operation of medical management programmes.
Provide clinical and business leadership in support of strategic business objectives.
Manage key partnerships and alliances to maximize Healthcare Quality
Promote quality and medical appropriateness of care.
Leader in improving and maintaining positive relations with clients, providers, facilities, partners and consultants. Business partner in network development strategy.
Support development of a marketable, high quality, cost effective provider network.
Mentor relevant employees and supports ongoing training and development of staff.
Manage relevant workforce and is responsible for all their performance management and employee development activities.
Requirements (Knowledge/Skills)
Board Certified, Licensed Medical Doctor.
Advanced degree in business or public health desirable
5+ years of Clinical experience desired
Heath Insurance Industry experience desirable
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