Associate Chief Medical Officer, Managed Care - Part-Time

Applicants may apply for this position by submitting a resume/ CV to the following email address: mgmtrecruit@cookcountyhhs.org

When submitting a resume/CV by email, you must include the job title and posting number in the subject line of your email. An application or resume/CV must be filed for each position which interests you.

This position is exempt from Career Service under the CCH Personnel Rules.

Job Summary

The Associate Chief Medical Officer, Managed Care (ACMO, MC) will assist with oversight of all medical care and medical management utilization review activities for Cook County Health (CCH) sponsored health plan serving Medicaid recipients or any other government sponsored program, under direction of the Chief Medical Officer, Managed Care (CMO, MC). The position serves as a medical policy advisor to the health plan leadership, as well as CCH leadership, for managed care members. The incumbent provides professional leadership and direction to the utilization/cost management and clinical quality management functions. The position assists CCH leadership in monitoring and developing capacity for primary care and specialty care services reflects the needs of current and anticipated managed care members. This position establishes collaborative working relationships with other managed care functions that interface with the contracted Third-Party Administrator such as medical management, provider relations, member services, and managed care operations and administration. Assists in short- and long-range program planning, total quality management and building external relationships.

NOTE: This is a part-time role (under 20 hours/week). Compensation commensurate with education and experience. Hourly Rate: Minimum $160/hour - Maximum $175/hour.

General Administrative Responsibilities

Collective Bargaining

• Review applicable Collective Bargaining Agreements and consult with Labor Relations to generate management proposals
• Participate in collective bargaining negotiations, caucus discussions and working meetings

Discipline

• Document, recommend and effectuate discipline at all levels
• Work closely with labor relations and/or labor counsel to effectuate and enforce applicable Collective Bargaining Agreements
• Initiate, authorize and complete disciplinary action pursuant to CCH system rules, policies, procedures and provision of applicable collective bargaining agreements

Supervision

• Direct and effectuate CCH management policies and practices
• Access and proficiently navigate CCH records system to obtain and review information necessary to execute provisions of applicable collective bargaining agreements

Management

• Contribute to the management of CCH staff and CCH' systemic development and success
• Discuss and develop CCH system policies and procedures
• Consistently use independent judgment to identify operational staffing issues and needs and perform the following functions as necessary; hire, transfer, suspend, layoff, recall, promote, discharge, assign, direct or discipline employees pursuant to applicable Collective Bargaining Agreements
• Work with Labor Relations to discern past practice when necessary

Typical Duties

• Assists with overseeing clinical strategy and clinical programs for physical and behavioral health
• Acts as liaison in the absence of the CMO, MC
• Providers oversight for Utilization Management Program, Care Coordination, Long-Term Services and Support, Quality Improvement, Accreditation, Credentialing, pharmacy, Appeals and Grievances, Health Services, Behavioral Health Services, and Medical Policy.
• Responsible for ensuring managed care members receive quality, cost effective health care
• Designs and implements managed care policies, goals and objectives
• Under the direction of the CMO, plans, organizes, and directs the medical services Health Plan Services program, consisting of all primary and specialty services for in-patient, out-patient, preventive and wellness programs
• Monitors and works with providers to develop and maintain appropriate capacity for these services to meet the needs of members
• Assists the CMO, MC in providing professional leadership and direction to the functions within the medical management department (Utilization, Clinical Quality Management and Credentialing)
• Supports collaborative relationships with physicians and hospitals
• Establishes, evaluates, and modifies medical decision-making policies and review criteria, as appropriate
• Performs other duties as deemed