Staff VP Medical Director, MSO (Management Services Organization)
Company: Elevance Health
Location: Salem
Posted on: May 27, 2023
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Job Description:
Staff VP Medical Director, MSO (Management Services
Organization)
Job Family: Medical and Clinical
Type: Full time
Date Posted:Apr 03, 2023
Req #: JR61258
Location:
CA, CERRITOS
National +50 Miles away from nearest PulsePoint, National +50 Miles
away from nearest PulsePoint
Description
Your Talent. Our Vision. At CareMore, a proud member of the Anthem,
Inc. family of companies, it's a powerful combination. It's the
foundation upon which we're creating greater access to care for our
members, greater value for our customers and greater health for our
communities. Join us and together we will drive the future of
health care.
CareMore is a proven care delivery model for the highest risk. We
are a team of committed clinicians and business leaders passionate
about transforming American healthcare delivery. We build and lead
integrated, multi-disciplinary clinical teams to care for the most
complex patients. We strive for excellence and have achieved
significant and measurable improvement in the total cost of care,
clinical outcomes, and experience. As an Anthem subsidiary, we
benefit from the scale and resources of one of America's largest
managed healthcare organizations.
Title: Staff Vice President, MSO (Management Services
Organization)
Location: This position will work in a hybrid model (remote and
office). The ideal candidate will live within 50 miles of one of
our Elevance Health PulsePoint locations.
Reports to the National Chief Medical Officer for CareMore & Aspire
Health
Travel: 10%
What Is CareMore?
CareMore is entering a new growth phase, as a proven care delivery
model for the highest risk. We are a team of committed clinicians
and business leaders passionate about transforming American
healthcare delivery. We build and lead integrated,
multi-disciplinary clinical teams to care for the most complex
patients and currently serve nearly 150,000 patients in most states
across Medicare, Medicaid, and commercial populations. We strive
for excellence and have achieved significant and measurable
improvement in the total cost of care, clinical outcomes, and
experience. As an Anthem subsidiary, we benefit from the scale and
resources of one of America's largest managed healthcare
organizations.
CareMore's Health Networks, Primary Care+, Touch, and CareMore@Home
models drive strategy, operations, and care delivery in our
national markets. Our comprehensive, upstream approach to health is
led by robust multidisciplinary teams of extensivists (managing
acute and post-acute episodes of care), primary care clinicians,
behavioral health clinicians, care management & engagement
specialists (including social workers, case managers, and community
health workers), virtual care providers, and mobile home-based care
teams. We continue to evolve our model to effectively engage and
care for complex patients, led by a team of passionate,
execution-minded leaders dedicated to this mission.
Responsible for the administration of medical services for company
health plans.
Primary duties may include, but are not limited to:
Manages medical performance for an assigned health services
area.
Interprets existing policies and develops new policies based on
changes in the healthcare or medical arena.
Leads, develops, directs, and implements clinical and non-clinical
activities that impact health care quality cost and outcomes.
Supports the Medical Management staff ensuring timely and
consistent responses to members and providers.
Identifies and develops opportunities for innovation to increase
effectiveness and quality.
Serves as a resource and consultant to other areas of the company
as needed.
May chair or serve on company committees and represent the company
to external entities and/or serves on external committees, and
provides guidance for clinical operational aspects of the
program.
Supports and adheres to and applies SMC, Federal, State, and
National Standard criteria to medical decision-making.
Hires, trains, coaches, counsels, and evaluates the performance of
direct reports and directly supervises the management of any
assigned staff (approx -250 FTEs).
Requires MD or DO and Board certification approved by one of the
following certifying boards is required, where applicable to duties
being performed, American Board of Medical Specialties (ABMS) or
American Osteopathic Association (AOA). Must possess an active
unrestricted medical license to practice medicine or a health
profession. Minimum of 10 years of clinical experience or any
combination of education and experience, which would provide an
equivalent background. For URAC-accredited areas, the following
professional competencies apply: Associates in this role are
expected to have strong oral, written, and interpersonal
communication skills, problem-solving skills, facilitation skills,
and analytical skills.
Preferred Skills, Capabilities, and Experiences:
Experience working with providers as business partners for a
managed care or health plan organization
Experience managing a team of Utilization Management/Case
Management direct reports (MDs)
Experience with STARS, HEDIS, and Quality scores
Experience working with Pharmacy and administration of Part B
benefits
MBA strongly preferred
For candidates working in person or remotely in the below
locations, the salary* range for this specific position is $297,040
to $445,560.
Locations: California; Colorado; Nevada; Washington State; Jersey
City, NJ; New York City, NY; Ithaca, 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 .
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. A Fortune 20
company with a longstanding history in the healthcare industry, 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 in certain
patient/member-facing roles 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
2022, has been ranked for five years running as one of the 2023
World's Most Admired Companies by Fortune magazine, and is a
growing Top 20 Fortune 500 Company. 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.
EEO is the Law
Equal Opportunity Employer / Disability / Veteran
Please use the links below to review statements of protection from
discrimination under Federal law for job applicants and
employees.
EEO Policy Statement
Know Your Rights
Pay Transparency
Privacy Notice for California Residents
Elevance Health, Inc. is anE-verify Employer
(https://www.e-verify.gov/sites/default/files/everify/posters/EVerifyParticipationPoster.pdf)
Need Assistance?
Email us (elevancehealth@icareerhelp.com) or call
1-877-204-7664
Keywords: Elevance Health, Salem , Staff VP Medical Director, MSO (Management Services Organization), Executive , Salem, Oregon
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