Chief Medical Officer / Chief Health Officer

Employer
Oklahoma Health Care Authority
Location
Oklahoma City, Oklahoma
Closing date
Jan 28, 2022

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Chief Medical Officer / Chief Health Officer

The Oklahoma Health Care Authority (OHCA) is the State Medicaid Agency of the State of Oklahoma. OHCA is searching for a Chief Medical Officer / Chief Health Officer. 

As an Executive Leadership Team member, this position will work in conjunction with the CEO and the Executive Leadership Team to strategically plan and collaboratively guide the overall management and operation of the Oklahoma Health Care Authority Agency.

The selected individual will direct the Medical Professional Services division, consisting of multiple agency departments, which includes the Medical Authorization & Review (MAR), Quality Assurance/Quality Improvement (QA/QI), Medical Administrative Support Services (MASS), and the Medical/Dental section. Will be consistent with state leadership and agency goals focused on health care delivery, innovation and payment reform to improve outcomes, contain costs and ensure program accountability and sustainability.

DUTIES INCLUDE THE FOLLOWING: 

  • As a member of the Executive Committee and the Operations team, this position provides regular input regarding the potential impact of policy and operational decisions on the delivery of quality health care to members and providers.
  • Provides coaching and direction to the Medical Directors, consultants etc. who are responsible for a wide variety of activities including determinations of medical necessity including prior authorization, legal appeals, approval or denial of out of state services, review of private duty nursing, and developing, communicating and recommending agency policy and guidelines to providers to meet the agency goal of providing access to and delivery of quality health care.
  • Emphasizes and promotes best practices in utilization management through the establishment of a robust utilization management program. Uses evidence-based decision-making to ensure Medical processes are carried out in an efficient and effective manner.
  • Facilitates frequent ongoing communication and interactions among the Medical Professional Services departments, as well as other areas, such as Population Care Management, Legal, Provider Contracting, Program Integrity, Policy, Finance, Provider Services, Business Enterprises and Behavioral Health etc. as is appropriate for the accomplishment of agency goals.
  • Coaching and support to the Directors of DMEPoS, Psychologists and Behavioral Health to assist them in efficient operation of their programs, and QI/QA, Medical Home/Health Access Network audit and review and Clinical Coding/Reference File and Post payment review. Coordinate requests for data analysis to the geneticist/medical data analyst.
  • Provide clinical direction for changes and modifications to the Clinical Claims editing system and reference file and to projects involving MMIS modifications, Fraud & Abuse, ICD-10 implementation and the MMIS re-procurement.
  • Prioritizing quality outcomes by providing administrative leadership to the Chief Quality Officer. Consult with and support the QI manager in overseeing the EQRO contract including the provider Education/Intervention Committee, Quality Reports, studies etc. Promotes and designs quality strategies to address social determinants of health.
  • Oversee and support the audit process for reviewing and improving the Medical Home contracts and education process. Provide support and recommendations for further development of the Medical Home and Health Access Networks.
  • Complete special projects as assigned such as legislative task forces, internal work groups, represent the agency and deliver presentations at local and national meetings. Participate in annual strategic planning meetings with other partners

REQUIREMENTS: 

CHIEF MEDICAL OFFICER

  • Medical Degree (MD or DO) from an accredited school of medicine recognized by national regulatory bodies in the US
  • Minimum of 5-10 years of post -graduate experience in direct patient care with progressively more responsibility in a health care setting
  • Be board certified by an appropriate specialty college or program (or DO equivalent)
  • Three (3) years of medical management or supervisory experience as a medical professional
  • Current active state license with DEA privileges; if not fully licensed in OK, must complete licensing in OK within 6 months of hire
  • Must remain up to date with annual continuing education requirements
  • Capable of effectively communicating and motivating associates at all levels of the organization

CHIEF HEALTH OFFICER

  • Master’s Degree or higher from an accredited university
  • Minimum of 10 years of post -graduate experience in health care administration
  • Minimum of 5 years management and/or supervisory experience
  • Capable of effectively communicating and motivating associates at all levels of the organization
  • Experience in implementing utilization and quality improvement strategies/techniques and experience with physician behavior modification
  • Experience in developing medical policy, procedures and programs

BENEFITS:

-Health and Life Insurance

The State of Oklahoma offers a variety of health insurance plans for you and your family, including PPO and HMO plans, dental insurance and vision insurance.

The State of Oklahoma also provides $20,000 in life insurance with additional coverage available. Employees receive a monthly benefit allowance from $673-$1075 depending on your coverage options.

-Flexible Spending Accounts

Each employee can choose to enroll in health care and dependent care flexible spending accounts. Flexible spending accounts allow you to set aside money from payroll, before taxes, to use to pay medical and child care expenses.

-Annual and Sick Leave

Eligible employees accrue annual and sick leave. Full-time employees accrue 15 days of sick and 15 days of annual leave per year. Annual leave accrual increases with longevity.

-Paid Holidays

State employees receive 11 paid holidays per year.

-Longevity Payment Program

Eligible employees with two or more years of continuous service may receive an annual longevity payment based on accrued years of employment.

-Retirement

Eligible employees are offered a generous retirement package with vesting options.

APPLY TO: https://www.jobapscloud.com/OK/sup/bulpreview.asp?R1=220104&R2=UNCE&R3=05

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