Deputy Chief Medical Officer

About CalOptima
CalOptima is a county organized health system that administers publicly funded health care coverage for low-income children, adults, seniors and people with disabilities in Orange County, California. CalOptima’s mission is to provide members with access to quality health care services delivered in a cost-effective and compassionate manner. With $3.5 billion in annual revenue, CalOptima serves nearly 800,000 members, delivering services through 14 health networks. For the past five years, CalOptima has been rated the top quality Medi-Cal plan in California, according to the National Committee for Quality Assurance (NCQA) Medicaid Health Insurance Plan Ratings 2018–2019.

Position Summary:
Medi-Cal and Medicare managed care including understanding of contracts and at-risk arrangements with providers. Industry and professional standards of health care, utilization management, quality improvement and other medical management functions. Principles and techniques of effective human resource management, including training and evaluation and effective utilization of staff. Principles and practices of healthcare, health care systems, and medical administration. Required governmental and other reporting criteria (i.e. NCQA, HEDIS).

Position Requirements:
 – Medical Doctor degree from a fully accredited university.
 – Current, valid, unrestricted California Physician & Surgeon’s License with Board certification in area of specialty.
 – 8+ years medical managerial and practitioner experience that includes HMO, Medi-Cal/ Medicare and/or insurance required.

CalOptima’s Deputy Chief Medical Officer must possess the ability to:
 – Conceptualize, develop and implement health care delivery policy in an effective managed care system.
 – Plan, organize, and direct utilization review, quality management, case management, prior authorization and grievance activities.
 – Identify with providers as a practitioner and as a medical manager and provide effective influence and leadership.
 – Establish and maintain effective interpersonal relationships with all levels of staff, other programs, agencies, and the general public.
 – Provide leadership to a large staff and encourage the professional performance and development of subordinate staff.
 – Communicate effectively at all organizational levels and in situations requiring instructing, persuading, negotiating, consulting, and advising.
 – Effectively utilize computer and appropriate software (e.g. Microsoft Office Suite, etc.).

CalOptima’s Deputy Chief Medical Officer must have the knowledge of:
 – Medi-Cal and Medicare managed care including understanding of contracts and at-risk arrangements with providers.
 – Industry and professional standards of health care, utilization management, quality improvement and other medical management functions.
 – Principles and techniques of effective human resource management, including training and evaluation and effective utilization of staff.
 – Principles and practices of healthcare, health care systems, and medical administration.
 – Required governmental and other reporting criteria (i.e. NCQA, HEDIS).

Application Process
For a complete job description and to apply online, please go to www.caloptima.org. Questions can be directed to Debbie Neal, Senior Recruiter, 657-235-6891 or dneal@caloptima.org.

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