Chief Medical Officer Insurance Division, Phoenix, AZ
Banner Health believes leadership matters, and we look for people who share our vision making health care easier, so life can be better. Our leaders are at the front of health care transformation, planning the future of Banner Health. Join an organization committed to supporting the quadruple aim of providing population health services, medical management, managed care functions, and practice transformation.
The CMO for the Insurance Division will be accountable for a number of insurance products including Medicare, Medicaid, and Commercial. In addition, the insurance division creates synergies utilizing our Provider Network. You will have overall responsibility providing leadership, direction, and administration for ACO and value-based population management to include leading physician and care delivery strategy and implementation within a $7B integrated health care delivery system.
About Banner Insurance Division
Banner Insurance Division is an accountable care organization that joins Arizona’s largest health care provider, Banner Health, and an extensive network of primary care and specialty physicians to provide the most comprehensive health care solutions. We are known nationally as an innovative leader in new health care models, where insurance plans and physicians are coming together to work collaboratively to keep members in optimal health, while reducing costs.
- More than 6,000 providers - physicians and advanced practitioners
- More than 400,000 insurance division members
- 13 Banner Health hospitals, plus the Banner MD Anderson Cancer Center and Cardon Children's Medical Center
- Lab, surgery centers, urgent care, hospice, home care, and comprehensive array of clinical services
About Banner Health Corporate
Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care.
About Banner Health
Banner Health is one of the largest, nonprofit health care systems in the country and the leading nonprofit provider of hospital services in all the communities we serve. Throughout our network of hospitals, primary care health centers, research centers, labs, physician practices and more, our skilled and compassionate professionals use the latest technology to make health care easier, so life can be better. The many locations, career opportunities, and benefits offered at Banner Health help to make the Banner Journey unique and fulfilling for every employee.
This position has overall responsibility for providing leadership, direction, and administration of medical management, as well as the integration, coordination, and improvement of clinical care and patient safety for designated healthcare memberships and operations. This position is an essential leadership role responsible for guiding the development and implementation of medical policies, practices, and clinical programs system wide. This position, along with its team members, is responsible for driving, supporting and modeling a service-oriented culture focused on employee engagement, quality, patient safety, service excellence, fiscal responsibility, and the overall patient experience. Serves as a member of the executive leadership team for designated healthcare operations, building and supporting effective collegial relationships with applicable internal and external constituents and stakeholders and ensuring optimal operating effectiveness and strategic positioning.
- Promotes concepts and practice of quality improvement. Establishes and maintains effective working relationships with physician and provider stakeholders. Participates in review of qualifications, credentials, performance, and professional competence and character of physician and provider stakeholders. May participate in provider network professional review process and physician recruitment.
- Works within the appropriate leadership model to establish, monitor and improve aggregate clinical outcomes. Actively participates in or leads care management activities to improve patient safety, provide patient-centered, appropriate and timely care, reduce inappropriate variation, implement evidence-based standards, enhance efficiency and throughput, and evaluate innovative clinical methods and opportunities. Works with other leaders to assess and improve the professional practice of independent, contracted, and employed medical providers.
- Participates in coordination of patient and family disclosure of untoward events. Participates in patient grievance process as needed.
- Provides leadership, supervision, guidance and development for staff, articulating and demonstrating an expectation for continuous quality improvement, as well as continually supporting and exhibiting company values and service standards. Identifies and provides growth opportunities for staff. Provides clinical oversight for quality issues and programs by participating in the clinical oversight body. This body reviews and approves quality improvement projects, provides clinical guidance where needed and grants authority to the Clinical Management Team and the Quality Council.
- Strategizes and drives process improvements focused on innovative care delivery and/or operational models designed to improve clinical services, outcomes, patient throughput, and patient safety. Promotes a patient-centered, healing environment. Promotes the use and implementation of technology in the workplace in order to streamline operations, facilitate communications, and optimize work processes.
- Ensures and fosters a high level of collaboration within a highly matrixed team environment in order to coordinate activities, review work, exchange information, and resolve problems. Champions, models, and promotes service excellence philosophies and behaviors at the facility, regional, and system levels to enhance the overall patient experience.
- Functions as an integral member of the designated healthcare operations and system leadership teams, serving in an advisory capacity to applicable staff. In collaboration with leadership team members, directs and provides oversight regarding the strategic development, implementation, and maintenance of strong, comprehensive clinical and/or operational services and programs that meet system-wide organizational growth initiatives and the needs of patient populations in the community. Fosters the development and implementation of workforce initiatives effectively. Leads and influences change at the local, regional, and system levels.
- Along with other members of the leadership team, promotes financial stewardship and clinical excellence for the designated healthcare operations in both operational and capital acquisition processes, as needed. Allocates financial, information, and human capital for improvement activities, ensuring the efficient delivery of cost effective services to patients, physicians, and hospital departments. Establishes performance measures, assesses and evaluates operations, and works with department management to assure efficient and effective delivery of services.
Medical Doctorate or Doctor of Osteopathy Degree required with Board Certification or eligibility preferred and level of expertise typically gained through five years of experience in clinical practice. Must be eligible for or hold a current and unrestricted State license to practice medicine and preferably be eligible for medical staff privileges. (CMO's assigned to oversee the Specialty Pharmacy must hold a current and unrestricted State license).
Must be eligible for or hold a current and unrestricted State license to practice medicine and preferably be eligible for medical staff privileges
Three years of provider network leadership experience also preferred. Prior experience as a physician leader, for example a Medical Director or CMO for a large multi-specialty group practice, physician practice management organization, hospital/hospital system, or health plan. Experience with hospital organized medical staff, managed care organizations, and continuous quality improvement activities preferred. Proven experience and track record of predicting the futuristic relevancy and applicability of innovative industry trends, both technological and programmatic. Proven track record leading physician groups, including group facilitation, leadership development, team-building, performance management, and driving cultural change. Experience working with physicians to strategize and develop measurable improvements the quality of clinical care and patient satisfaction. Proven experience implementing a continuous improvement culture. Experience implementing and maintaining a patient-centered, healing culture. Proven track record of partnering with medical staff to achieve desired facility-specific and organizational outcomes. Knowledge of modern national trends in hospital technology, quality and patient safety. Skilled in effectively handling multiple conflicting assignments, demands, and priorities with great attention to detail; coaching and developing direct reports and/or other employees by providing open and honest feedback that results in enhanced performance outcomes; establishing, pursuing, and monitoring appropriate process and outcome measures for key initiatives utilizing a systems perspective; evaluating the processes by which clinical care and patient services are delivered, identifying areas for of opportunity, setting standards for outcomes, developing appropriate systems to monitor outcomes, and overseeing the implementation of process improvements; quickly assessing and assimilating industry trends in order to act quickly and appropriately to changing environmental factors; influencing others and translating strategies into actions; motivating physicians and building teams; influencing physician behaviors; partnering and problem solving with physicians and administrative leaders within multiple clinical areas and among members of the medical staff; navigating a highly-matrixed organizational structure with skill and efficiency; analyzing complex financial/statistical data; maintaining a high level of organization with strong attention to detail in order to respond quickly to varying situations. Excellent human relations, organizational and communication skills are essential. Leadership style and characteristics necessary to effectively perform in this role include: strong work ethic; results-oriented; persuasive; motivational; able to make rational decisions in difficult situations; inspirational; honorable; confident; systems-thinker; innovative; life-long learner; courageous; high-energy; integrity; collaborator; ability to work with teams; good listening; nonvolatile; values multiple disciplines; and passionate about continuously improving and providing high quality care and service excellence to patients, families, employees and physicians.
Additional related education and/or experience preferred.