Chief Medical Officer

This is an outstanding opportunity to join Health Plan of San Mateo (HPSM), which is recognized as one of the most innovative and progressive mid-sized public health plans in the nation, in a key leadership role of Chief Medical Officer (CMO). With approximately 145,000 members, HPSM serves primarily Medi-Cal Managed Care and California’s Dual Eligible Demonstration РCal MediConnect plan members, and provides a diverse array of quality and patient oriented services including an innovative program to keep members out of nursing homes. The organization enjoys excellent working relationships with the California Department of Managed Health Care, California Department of Health Care Services, related County agencies, and community-based not-for-profit partner organizations and often is called upon by the State to pilot demonstration projects. Of the 53 health plans offering Medi-Cal coverage to various counties in California, HPSM ranks sixth in the state on HEDIS Aggregated Quality Factor Score.

The CMO will bring a coordinated focus to population health for the membership and craft a vision and take that forward for the County of San Mateo. S/He will be responsible for leading efforts to provide innovative solutions that support more affordable and better quality health care, empower members to achieve health and wellness, and offer superior service to the constituents served by HPSM.

Reporting to the Chief Executive Officer, the CMO is a key member of the executive leadership team, providing medical leadership and strategic direction for HPSM and includes oversight of the Health Services Department, Pharmacy Department, and Quality Department. The CMO is responsible for providing direction in the areas of utilization, care management and care coordination, quality, clinical analytics and medical management, and pharmacy in a manner that promotes high quality and cost effective health care services for plan members. This includes leadership and oversight for initiatives which will impact the care management spectrum including the coordination of responsibilities of the Associate Medical Directors and senior staff in the Health Services division.

HPSM seeks a leader who embraces involvement in strategic issues regarding the medical direction of the organization, as well as day to day responsibilities involving team performance, clinical performance, quality improvement, and provider and member satisfaction.

Successful candidates will ideally have: Minimum of ten (10) years broad based medical experience related to utilization review and quality improvement and at least five (5) years in a management role; At least three years of medical management experience in a managed care plan or delegated medical group/medical foundation, or IPA; Experience and/or significant interest and commitment to public health and the Medi-Cal/Medicaid and Medicare population/programs. Knowledge of Medicare, Part D Medicare, and Medi-Cal programs preferred; At least five years clinical experience, ideally in a practice contracting with managed care plans; An appreciation and support for medical/clinical analytics, ideally experienced at establishing and utilizing well-designed comparative data, analyzing the data, and taking appropriate actions from such.

Please direct nominations and inquiries to the Witt/Kieffer consultants, Elaina Genser and Steve Yamada, through the office of Sue LeGrand, or 314-718-4603.

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