Chief Medical Officer - Value Based Care

The Chief Medical Officer (CMO) of VCU Health System Value-Based Care (VBC) serves as the clinical executive responsible for leading VCU Health’s Employee Health Plan, CIN, Direct to Employer, and other Value-Based Care initiatives. This leader will be primarily responsible for designing, leading, and optimizing the clinical care model and care teams supporting Direct-to-Employer customers, including oversight of the Center for Team Care—a comprehensive primary care and population health program for VCU Health employees that serves as a foundation for future direct-to-employer partnerships. This leader will build the Value-Based Care entity’s innovative care model, population health, and utilization management programs in such a way as to best serve VCU Health’s employees, its CIN at-risk population, and future employer-customers’ populations to achieve the Quadruple Aim of Better Care, Better Affordability, Better Patient Experience, and Better Provider Satisfaction. This leader will also serve as an internal and market-facing champion and thought leader for VCU Health’s Value-Based Care and Health Care Services Initiatives. The incumbent will creatively design care and population health programs, lead diverse internal care teams, and consult with benefits leaders and executives – both within VCU Health and with external employers - on benefit design, clinical model design, and the best strategies to achieve maximum value for employee benefits and health care spend. The CMO will maintain relationships with clinical and non-clinical executive leaders, current and prospective customers, and across the community to grow the VCU Health brand and expand business opportunities for VCU Health’s Value-Based entity and business lines.

Essential Job Statements

Develop and execute the clinical strategy for VCUHS’ value-based care model, ensuring the delivery of high-quality, patient-centered care, utilization management, total cost-of-care initiatives, and governance.  Sets the clinical vision, develops and implements new population health programs, aligns clinical operations with organizational goals, and develops a strategy for the continued growth of the Direct to Employer and CIN service lines.

Uses data to identify high-risk populations and design targeted interventions.  Develop and lead the strategy for risk prediction to optimally identify patients for proactive outreach within Direct-to-Employer and CIN populations.

Leads clinical transformation initiatives for the Value-Based Population to improve patient safety, clinical effectiveness, and regulatory compliance.  Coordinates with the Chief Quality and Safety Officer to establish metrics and accountability structures for continuous improvement across all value-based contracts and key performance metrics.

Partners with Senior Leadership, CIN Boards, and CIN community practices to optimize clinical workflows, resource utilization, financial stewardship, and the benefit appeals process.

Collaborates with Finance and Managed Care contracting teams to evaluate and manage clinical risk in shared savings, capitation, and downside risk arrangements, and optimizes current pay-for-performance contract terms.  Identify, develop, and lead initiatives to reduce medical and pharmacy cost trends and increase the value of benefits in Direct-to-Employer and CIN populations.

Consult with Direct to Employer customers on benefit design enhancements to improve the value of benefits, the health of employee populations, and medical cost trends.  Partner closely with their PBMs and TPAs to develop the highest value benefit plans.

Builds strong relationships with Nursing, Allied Health, and Administrative Leadership to promote integrated patient care delivery.

Champion the adoption of new technologies and evidence-based practices to enhance patient outcomes and system efficiency.  Partners with CMIO and IT to optimize EHR workflows, data integration, and clinical decision support tools in support of the IT roadmap for value-based care.

Ensures compliance with accreditation standards (e.g., Joint Commission), federal and state regulations (e.g., HIPAA, CMS), and professional guidelines.

Recruit, develop, and retain a high-performing value-based care clinical team.

Performs other duties as assigned and/or participates in special projects to support the mission of VCUHS and the team.  Accepting alternative responsibilities as required.

Patient Population: N/A

Employment Qualifications

Education Required: Medical degree (MD, DO, or equivalent) with board certification in a medical or surgical specialty

Education Preferred: Clinical leadership training. MHA, MPH, MSHA, MBA, or a related graduate degree.

Licensing/ Certification

Licensure