Chief Medical Officer

LEADERSHIP EXPECTATIONS :

• Strategic Thinking - Adapt to changes in the marketplace. Identify short and long-term functional goals and strategies. Lead change efforts in redefining how to serve customers.
• Organizational Development - Implement organization structure and communicates roles/accountabilities. Identify, develop, and engage functional talent. Identify workforce gaps and develop talent to fill gaps. Hold Directors accountable for developing others and managing performance. Identify key talent/high potentials and inform Senior Leaders. Recognize and celebrate success.
• Transparent Communication - Constantly discuss business strategy with functional leaders; ensure employees understand how what they do links to strategy. Frequently cascade information up and down the organization. Model transparency with dashboard/metrics. Clearly and effectively communicate.
• Lives the Values - Make decisions that support the values. Demonstrate the values in daily activities. Hold Directors accountable for living the values. Place Company and team above self.
• Continuous Improvement - Set stretch goals that improve performance. Take measured risks and develop contingency plans, when needed. Develop new ways of getting work done that supports innovation efforts. Proactively work to improve processes. Promote and reward efforts to make the work environment open to new ideas and thinking. Continuously enhance and improve own contribution.
• Accountability - Hold self and Directors accountable for achieving results. Identify and remove obstacles to getting things done.
  Make decisions in timely manner. Display ability to make difficult decisions.

SUMMARY OF POSITIONAL RESPONSIBILITIES :

• Provide leadership and direction to fulfill the EmblemHealth (EH) mission of providing access to affordable quality health coverage. Develops short- and long-term strategies that improve medical outcomes and affordability of member care. Promotes wellness and ensures programs of prevention, education and outreach to members and providers are consistent with EH’s mission, vision and values.
• Develops and implements medical policies and monitors progress against goals and objectives. Reviews and influences medical utilization, cost and quality outcomes. Develops and implements action plans based upon data and information relative to health care cost trends. Guides leadership and staff, including providing medical education and clinical development to plan staff and provides direction relative to plan philosophy.
• Oversees the development of budgets and staffing plans, assuring the adequate allocation of resources to the various functions. Recruits, develops, and retains professionals and staff who are focused on quality and service for the member and provider.
• Collaborates with colleagues in reviewing existing and developing new programs which support the effectiveness of healthcare delivery within the network of professional providers, facilities and vendors.
• Represents the Office of the CMO internally and externally at medical group meetings, industry trade groups, conferences, etc. Supports other areas in implementing cross-departmental changes. Develops goals with staff to ensure linkage with overall organizational goals. Assures conformance with legal and regulatory requirements. Represents EmblemHealth to regulatory agencies on medical matters and serves as the key contact for regulators on medical policies and compliance.
• Keeps abreast of competitor capabilities and remains alert to trends and future policies as they relate to changes which might impact the business. Maintains up-to-date knowledge of new information and technologies in medicine and their application to EmblemHealth.
• Set the strategic direction for the enterprise’s mainstream pharmacy business by providing leadership for all pharmacy programs including patient care, research, academic training and business affairs.
• Responsible for all aspects of the enterprises Pharmacy Services including strategic planning, business and operational oversight, business development, maintaining internal and external collaborative partnerships, regulatory oversight and planning and continuous improvement activities to deliver exceptional financial outcomes.
• Provides leadership and establishes productive relationships with Senior Leadership, medical staff, and department heads to optimize all aspects of medication management and formulary management across the enterprise.

DELIVERABLES :

• Makes significant contributions towards EmblemHealth’s short- and long-term business initiatives which include Operating Income, Administrative Expenses, Medicare & Medicaid ratings, and Net Promoter Score performance. [specific metrics and benchmarks to be provided]
• Identifies, hires, & trains staff members, developing them into strong leaders and creating high-performing, self-directed teams. Effectively plans for succession planning ensuring talent pipeline.
• Acts as change agent to drive and effect organizational change ensuring key deliverables are met. [specifics to be provided]