Location
Billings, MT, United States
Posted on
Apr 11, 2023
Profile
Job Information
Humana
CMO - Regional VP, Health Services - Intermountain Region
in
Billings
Montana
Description
The Regional VP, Health Services relies on medical background and reviews health claims. The Regional VP, Health Services requires a in-depth understanding of how organization capabilities interrelate across segments and/or enterprise-wide.
Responsibilities
The Regional VP, Health Services (Chief Medical Officer) will serve over the Intermountain Region (WA/OR/UT/ID/WY/MT/AK). The RVP provides medical interpretation and decisions about the appropriateness of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. Decisions are typically related to intradepartmental coordination, development and implementation of strategic plans, and business outcomes, and develops and implements strategic plans for the scope of management that are aligned with the Segment or Business strategy.
Required Qualifications
*5 or more years of management experience
*A current and unrestricted license in at least one jurisdiction and willing to obtain license, as required, for various states in region of assignment
*MD or DO degree
*Board Certified in an approved ABMS Medical Specialty
*Excellent communication skills
*5 years of established clinical experience
*Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products
*Prior experience leading teams focusing on quality management, utilization management, discharge planning and/or home health or rehab
*Must be passionate about contributing to an organization focused on continuously improving consumer experiences
* Possess analytical and interpretation skills
Preferred Qualifications
*Medical management experience, working with health insurance organizations, hospitals and other healthcare providers, patient interaction, etc.
*Internal Medicine, Family Practice, Geriatrics, Hospitalist, ER, PM&R clinical specialists
*Master's Degree
*Experience working with Value Base contracts within MA, Medicaid or Dual plans
*Candidate will reside within Intermountain Region (WA/OR/UT/ID/WY/MT/AK)
Additional Information
Must reside in of the following states -WA/OR/UT/ID/WY/MT/AL Role can be Hybrid at Home, with travel to meetings and office as business needs
*Travel: minimum of 25%
#PhysicianCareers
Scheduled Weekly Hours
40
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ****
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