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CareMore Reg Chief Med Officer - East Region

Location:

  • GA, Atlanta
  • New Jersey, New Jersey
  • Connecticut, Connecticut
  • Virginia, Virginia
  • New York, New York

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Description

CareMore is a proud member of the Elevance Health family of brands, offering clinical programs and primary care options for seniors. We are a team of committed clinicians and business leaders passionate about transforming American healthcare delivery.

In this role you will be responsible for partnering with business, operations, and growth leaders to support business growth in the defined markets. Maintains a high level of touch with prospects and members to ensure that aggressive growth targets are achieved.  Responsible for clinical operations and medical staff within the East and Central region.

This is a predominately work-at-home position but you must be able to support both Central and Eastern Time Zones.

With the Elevance Health rebranding, we are no longer under “Diversified Business Group.”  Instead, we are a part of a very dynamic care delivery arm of Elevance called Carelon.  Carelon includes physical and behavioral health, pharmacy, home health, palliative care, and a robust analytics group.  There is a rich, collaborative spirit among the lines of business within Carelon.  Elevance Health sees Carelon as it's most important strategic partner for future growth.

Primary duties may include, but are not limited to:

  • Leads clinical performance and strategy for multiple markets and is accountable for population clinical outcomes and quality, clinical staffing and training, care coordination and alignment with network providers, and overall clinical and financial performance.

  • Oversees each market including hospital; care centers; home visits; and network provider offices to optimize clinical and financial performance.

  • Provides strategic and operational direction for the delivery of performance-based medical management.

  • Responsible for clinical outcomes across acute and post-acute care, ambulatory care and chronic disease management, and specialty care for all patients and markets under purview.

  • Monitors data to ensure that network providers are providing high quality service to members at a reasonable cost; are effectively working to improve clinical performance, coding, and HEDIS/Star gap measures; and meets regularly with critical primary care and specialty groups to ensure that there is a deep understanding of both performance expectations and the CareMore model.

  • Manages budget and risk drivers.

  • Analyzes and reports business performance data to customers, senior management, and company leadership.

  •  Analyzes local profit and loss performance.

  • Contributes to the internal and external health industry development efforts.

  • Hires, trains, coaches, counsels, and evaluates performance of direct reports.

Requires MD or DO and a minimum of 5 years of experience as a hospitalist or internist and a minimum of 10 years combined administrative and leadership experience; or any combination of education and experience, which would provide an equivalent background. Requires current unrestricted medical licensure in applicable state(s). Board certification from the American Board of Medical Specialties (ABMS) or American Osteopathic Association (AOA) is required.

Preferred Skills, Capabilities and Experiences:

  • Experience in inpatient and outpatient care delivery models servicing Medicare and Medicaid and Commercial patients

  • Experience in Medicare Advantage with dual, chronic, and institutionalized special needs plan patients

  • Strong knowledge of risk agreements

  • Experience in Utilization Management and Cost of Care initiatives

  • Understanding CMS regulations

  • Experience in partnering through CMS Audit process

  • Understanding of Hospital systems coupled with Healthplan knowledge

  • Internal, Family Medicine, and/or Geriatric Specialties are highly desirable

For CareMore business units, satisfactory completion of a Tuberculosis test is a requirement for this position.

For candidates working in person or remotely in the below locations, the salary* range for this specific position is $287,520 to $517,536

Locations:  Colorado; Nevada, Jersey City, NJ; New York City, NY; Ithica, NY and Westchester County, NY

In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company.  The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws .

* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.


Please be advised that Elevance Health only accepts resumes from agencies that have a signed agreement with Elevance Health. Accordingly, Elevance Health is not obligated to pay referral fees to any agency that is not a party to an agreement with Elevance Health. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Be part of an Extraordinary Team

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.

We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.ElevanceHealth.com. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.

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