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Successor to CCO
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TriWest Healthcare Alliance
Remote
Full-Time
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Job Description
Successor to CCO at TriWest Healthcare Alliance Successor to CCO at TriWest Healthcare Alliance in Las Vegas, Nevada Posted in about 19 hours ago.
Type:
Full-Time Job Description:
We offer remote work opportunities (FL). Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position. Veterans, Reservists, Guardsmen and military family members are encouraged to apply! Job Summary Directs and coordinates clinical operations for DoD and VA contracts. Oversees all clinical operations to include medical management, behavioral health, clinical quality, case management, utilization management, referral management and disease management. Support clinical leadership team in achieving operational goals and requirements. Represents TriWest with external stakeholders and customers and builds collaborative relationships.Education & Experience Required:
- MD or DO degree obtained from an institution accredited by the Liaison Committee on Medical Education and listed in Association of American Medical Colleges
- Board-certified by a recognized MD or DO specialty board
- Holds current unrestricted license to practice medicine
- U.S. Citizen
- Must be able to receive a favorable Interim and adjudicated final Department of Defense (DoD) background investigation
- 10+ years medical practice experience
- 10+ years senior medical management experience
- 10+ years diverse management experience
Preferred:
- TRICARE or Veterans Affairs (VA) experience
- Familiarity with government, VA, DoD or military medical systems
- Background in health care systems and customer service or equivalent experience
- Veteran
- 5+ years managed care experience Key Responsibilities
- Functions as a senior clinical operations leader liaison between the President and shareholders.
- Oversees the quality assessment program and chairs the Quality Management and Improvement Committee and co-chairs joint quality committees.
- Analyzes overall enterprise performance.
- Directs and oversees communications to leadership and staff to ensure a streamlined and consistent process for servicing shareholders, partners and customers.
- Oversees customer access to care and monitors network adequacy.
- Oversees analysis of financial impact studies to manage and evaluate contract changes and health care costs.
- Oversees and assists in the development and negotiation of contracts.
- Ensures compliance with contract requirements.
- Analyzes reports for and from shareholders, contract representatives, and TriWest senior leadership to define operational activities, goals, and objectives.
- Provides guidance for clinical operational aspects and is responsible for oversight of clinical decision-making aspects of the quality program.
- Ensures the organizational objective to have qualified clinicians accountable to the organization for decisions affecting consumers.
- Has periodic consultation with practitioners in the field.
- Analyzes, develops and implements continuous quality improvement processes.
- Develops and maintains production standards ensuring quality control, timely and accurate management of workload.
- Functions as a senior clinical consultant to senior leadership and other TriWest divisions.
- Functions as principal clinical liaison with contracted entities.
- Coordinates and oversees programs, processes, and projects.
- Provides senior leadership to medical and behavioral health management teams.
- Provides strategic planning in setting division objectives.
- Counsels staff regarding clinical decisions or reviews as necessary.
- Performs other duties as assigned to support the TriWest mission.
- Regular and reliable attendance is required.
People Skills:
Ability to influence or persuade others under positive or negative circumstances; adapt to different styles; listen critically; collaborate.Computer Literacy:
Ability to function in a multi-system Microsoft environment using Word, Outlook, TriWest Intranet, the Internet, and department software applications. Independent Thinking /Self-Initiative:
Critical thinker with ability to focus on things which matter most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources.Information Management:
Ability to manage large amounts of complex information easily, communicate clearly, and draw sound conclusions.Leadership:
Successfully manage diverse work force; provide clear direction and effective coaching.Organizational Skills:
Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; detail-oriented.Technical Skills:
Experience managing significant section of a health care organization; experience with health care services; comprehensive knowledge of clinical quality management; Comprehensive knowledge of managed care; Knowledge of budgeting processes; business planning experience; experience developing annual budget and staffing projections; proficient with Microsoft Word, Excel, Outlook, PowerPoint and the use of the Internet.Working Conditions Working Conditions:
- Available to work non-regular hours as required.
- Works a hybrid work environment, with up to 25% travel.
- Extensive computer work, with prolonged sitting.
- Security clearance as needed.