North Carolina Department of Health and Human Services
Details
Posted:
April 13, 2018
Location:
Raleigh, North Carolina
Salary:
$137,000 - $195,000
Type:
Full Time - Experienced
Discipline:
Executive
Required Education:
MD/DO
The Division of Medical Assistance (DMA) manages health care services for the most vulnerable North Carolina residents. With a budget of nearly $14 billion, DMA serves about 2 million low-income parents, children, seniors, and people with disabilities through the NC Medicaid and NC Health Choice for Children programs.
Position Summary
The Chief Medical Officer (CMO) functions as a key member of the Division Executive Team, providing input into policy decisions and medical leadership to all Medicaid sections and initiatives, with the goal of promoting the delivery of high quality services within a sustainable budget. The position will also have management responsibilities. The CMO will interact on a regular basis with Pre-Paid Health Plans (PHP) and Local Management Entities/Managed Care Organizations (LME/MCO) medical directors and clinical and non-clinical staff in other state agencies including the Division of Public Health, Division of Mental Health, Intellectual & Developmental Disabilities, and Substance Abuse, and others as needed. Other key responsibilities include analysis of proposed legislation and testimony at legislative committee meetings, input on state-related payment reform, leadership on Social Determinants, and serving as a liaison to the healthcare provider community.
Job Specific Responsibilities
Lead, direct and/or give implementation support to programs that improve the health or quality of care for populations served
Lead, orchestrate, implement and/or sponsor programs to evaluate the quality of care. This evaluation enables leveraging of new or existing purchasing strategies
Lead Medicaid efforts in improving the Social Determinants of Health for Medicaid Beneficiaries
Develop, lead and/or participate in quality oversight for significant aspects of Medicaid/CHIP work and compliance
Provide medical leadership and consultation for benefit design
Provide direct medical consultation for policy development, case reviews, appeals
Serve as liaison with health care providers, Health Plan medical directors, other DHHS Medical Directors, and other DHHS and external clinical partners to achieve program goals
Knowledge, Skills and Abilities
Working knowledge of
Delivery system redesign
Quality improvement principles
Utilization management principles
Evidence-based, patient-centered care principles
Disease management and care coordination principles
Insurance industry and managed care principles
Demonstrated ability to be data driven, with a working knowledge of management information systems, statistical analysis, and outcome data analysis
Proven skills developing and implementing practice guidelines
Implementation experience in change management
Understanding of and commitment to public/population health principles
Solid written and oral communication skills, including the ability to articulate issues in a concise manner, understandable to a wide range of audiences
Extensive understanding of the health care delivery system and the health care marketplace
Understanding of the basic authority (state and federal law and rules) governing Medicaid and CHIP programs
Understanding of how to participate in the legislative process as a lead professional state agency representative
Effective interpersonal influence, collaboration and listening skills
Proven ability to listen, collaborate, problem-solve, and negotiate with colleagues and adversaries
Solid management skills necessary to inspire, seek consensus, build teams, and manage conflict
Strong leadership skills necessary to analyze and articulate complex policy concepts, envision change, and promote creative and innovative approaches
Must be able to obtain a medical license in North Carolina (If not currently licensed to practice medicine in the State of North Carolina)
Management prefers
MD or DO, Board certified in pediatrics, family medicine or internal medicine preferred; other specialties with appropriate experience
Advance degree: MPH, MBA, MPP or related degree
Minimum of seven years of clinical experience as a practicing physician with three years of serving Medicaid clients preferred
At least two years of direct administrative experience with a state Medicaid program or managed care organization preferred
