Provide medical oversight, expertise and leadership to ensure the delivery of cost effective, quality healthcare services to health plan members.
Serves as clinical advisor to and educator of medical management staff.
Provide leadership and expertise in the development, implementation and interpretation of medical review and quality related policies and guidelines.
Provide oversight and direction for staff and provider training and education.
Promote positive relations with the local medical community.
Review case management data, identifies trends and gaps in care and recommends corrective actions.
Review all quality of care issues and oversees the development and implementation of processes for improvement.
Monitor performance indicators to ensure the delivery of cost-effective care within quality standards.
Monitor member and provider satisfaction and recommends and implements changes to improve satisfaction levels.
Work collaboratively to develop corporate clinical care standards and medical practice policies.
Provide medical guidance to the Medical Management department.

MD or DO without restrictions
Board Certified Physician
Louisiana license
Louisiana resident
Medicaid experience highly preferred
7+ years clinical experience in the practice of medicine required
Management experience preferred
Utilization Management experience preferred
Course work in Health Administration, Health Financing, Insurance, and/or Personnel Management preferred
Experience treating or managing care for a culturally diverse population preferred

Chief Medical Officer

Key skills