SVP, Chief Medical Officer

Senior Vice President, Chief Medical Officer

The role of the Priority Health SVP, Chief Medical Officer is to provide overall clinical leadership in a manner that is focused on achieving optimal care for our members and aligns with the overall Corewell Health system goals, including quality, affordability, equitable, safety and member experience. This position provides leadership, direction, and oversight for all areas of the medical department including Innovation & Transformation, Medical Management, Medical Operations, Care Management, Behavioral Health, Pharmacy, the Medical Directors and Clinical Quality Improvement. This role also provides strategic clinical guiding principles for the organization.

Essential Functions - SVP, Chief Medical Officer

• Participate in strategic planning both within Priority Health and at the Corewell Health system level, particularly as it relates to clinical and provider-related issues; strong emphasis on Total Cost of Care and ensuring market goals on affordability are supported by the team. Provide strategic leadership for innovative and transformational medical management initiatives that improve the health outcomes of our members.
• Lead in the development and coordination of clinical / population health programs, utilizing the team members available within Priority Health and, when appropriate, from across the Corewell Health system. This includes new care management programs to drive down trend and cost of care, potentially including partnering with the care delivery system (internal and external) on UM / CM best practices and shared operations.
• Maintain collaborative relationships with providers and provider organizations across the State, and within the integrated system with a strong orientation towards integrated strategy and value, reducing admin inefficiencies, and enhancing quality and experience / reducing friction by aligning on evidence-based guidelines to reduce unnecessary variability and waste.
• Participate in and guide population health initiatives including disease burden, value of UM / CM / Programs, care management delegation when warranted, equity, SDOH, clinically oriented COE's, and clinical pathways.
• Provide strategic leadership for core Medical Management and Rx Operations, including credentialing, formularies, UM / CM, member engagement, policy development / alignment / synchronization.
• Partner on developing and executing all parts of the Visible Value priority that drives affordability and greater growth, including Quality, Value, Medical Trend, Cost Management and Experience. Directs Technical Assessment and Medical Affairs Committees to support the overall strategic priorities.
• Interact with and effectively represent Priority Health with employers, consumers and the communities we serve. Communicate effectively with the Priority Health Board of Directors.
• Participate with organizations regionally, state-wide, and nationally; be our key spokesperson on key policy issues. Dedicate efforts to further our Vision of a future where health is simple, affordable, equitable and exceptional and support our Mission to improve health, instill humanity and inspire hope.

Qualifications - SVP, Chief Medical Officer

Physical Demands - SVP, Chief Medical Officer

5 lbs : Seldom up to 10 lbs

5 lbs : Seldom up to 10 lbs

5 lbs : Seldom up to 10 lbs

5 lbs : Seldom up to 10 lbs

5 lbs : Seldom up to 10 lbs

5 lbs : Seldom up to 10 lbs

5 lbs : Seldom up to 10 lbs

5 lbs : Seldom up to 10 lbs

5 lbs : Seldom

2 lbs : Seldom

Primary Location

SITE - Priority Health - 1231 E Beltline - Grand Rapids

Department Name

PH - Executive Medical Director

Employment Type

Full time

Shift

Day (United States of America)

Weekly Scheduled Hours

40

Hours of Work

8 : 00 a.m. to 5 : 00 p.m.

Days Worked

Monday to Friday

Weekend Frequency

N / A