Medical Director – CCO – $2,000 Sign On Bonus
To apply visit www.careoregon.org/careers and search for Medical Director – CCO (requisition 16787) in our careers portal. If you have any difficulty submitting your resume through the online process, please let us know by emailing email@example.com.
Are you excited to step into a complex world that requires a blend of mind, heart and flexibility? We at CareOregon have been strengthening communities since 1994 by making health care work for everyone. As a nonprofit health plan largely focused on Oregon’s Medicaid population, we find fulfillment in supporting the underserved.
And we’re committed to that work in various areas of our wondrous state—including Jackson County, in Southern Oregon. The region is anchored by the small city of Medford, home to our office and in easy reach of rushing rivers, the Pacific coast, Shakespearean plays, wine country, and the majesty of the Rogue River-Siskiyou National Forest. Please consider joining us here at Jackson Care Connect, our Coordinated Care Organization dedicated to our members’ physical, emotional and oral health. We look forward to your application!
To protect the health and well-being of our members, employees and community, CareOregon requires all employees to be fully vaccinated against COVID-19 or have an approved medical or religious exception as a qualification of employment.
Candidates who receive an offer of employment by CareOregon, must provide proof of COVID-19 vaccination or submit a medical or religious exception request, which will be evaluated in accordance with CareOregon’s standard accommodation process.
General Statement of Duties
This position is responsible for leading the execution of provider contracting strategy and activity across the organization. The majority of time is focused on business group oversight, with secondary time on enterprise-wide engagement. Primary duties include technical and operational planning and oversight, as well as resource, relationship, and people management. This position provides input into strategic plans for the broader organization.
Essential Position Functions
Directs provider contracting services across all areas of the organization in support of Medicaid, Medicare, and other populations.
Leads the execution of strategic initiatives, plans, and goals for areas of oversight in alignment with organizational vision and goals.
Develops, operationalizes, and maintains effective alternative payment models to support delivery system transformation in partnership with internal and external teams (e.g., PCP Payment Model, Risk Agreements).
Ensures Network and VBP strategies are supported by evidence base and best practices that relate to the models being developed; integrates findings into the design of methodologies.
Works with internal leaders in the development, implementation, and maintenance of quality payment strategies and risk models within regional networks.
Advises leadership on ways to improve CareOregon’s strategic positioning to support its current and future provider network and strategic partners; collaborates with leadership in the development and negotiation of complex contractual and financial arrangements with complex providers (e.g., hospitals, primary care physicians and ancillary providers).
Develops and maintains process to evaluate financial and network impact of alternative payment methodologies and continually review and adjust strategies accordingly in conjunction with actuarial staff.
Assists in the development, implementation and maintenance of analytical plans and evaluation plans of developed models in quality of care, health care utilization, and cost trends as necessary for the program.
Oversees and ensures the timely completion of value-based payment regulatory reporting.
Develops or ensures internal systems and measures are in place to support effective, efficient, and compliant operations.
Provide oversight of the development and maintenance of policies, procedures, structures and training to support the staff and department into the future.
May serve as a sponsor or chair for key projects and initiatives.
Effectively articulate and disseminate models and innovation results using a variety of communication channels to include written reports, graphic data display, PowerPoint presentations, speaking engagements, and manuscript publications.
Leads the oversight of alternative value based payment strategies in partnership with NCS that supports delivery system transformation across multiple mechanisms of payment (payment methodology, incentive payments and shared savings, grant programs, etc.).
Develops, operationalizes, and maintains a Network Risk Strategy that supports the Network, Members and CareOregon’s needs and capitalizes on the existing Risk Model work, regional and national initiatives.
Participates in the development of vision, goals, and strategic plans across business teams and regions.
Develops short and long term plans and policies; oversees the development and execution of standard operating procedures.
Provides input into strategic plans of the organization.
Maintains a business unit and member view while establishing department priorities, being cognizant of broader business unit and organizational impacts.
Recommends budgets in alignment with short and long term plans.
Manages resources to ensure priorities are accomplished.
Approves resource allocations within budget, including people, finances, and timelines; make decisions on exceptions.
Builds and ensures effective relationships across internal teams, line of business customers/stakeholders, and external organizations for current or future integration.
Partners with internal leaders and managers in identifying improvement plans and processes.
Works closely with the internal leaders to ensure that agreements, relationships, reporting and programs are properly supported for our members and our network partners.
Cultivates strong business relationships with the provider community.
Represents CareOregon in external meetings and functions, providing productive leadership presence and effectiveness.
Leads effective communication system for work group(s), ensuring a collaborative culture.
Directs team(s) and establishes team and management goals.
Provides team members with ongoing understanding of business unit plans and expectations.
Performs employment functions in collaboration with Human Resources, including staffing, recruitment, performance management, professional development, and termination.
Coaches, motivates, and recognizes staff.
Creates opportunities for professional development.
Leads the development of performance goals, measurement, and evaluation of results.
Ensures participation in required training initiatives and organizational activities, as well as adherence to external regulations and internal policies.
Drives a culture of success in alignment with the organizational mission, vision, and values.
Provides support and coaching to teams working in a complex matrix environment.
Education and/or Experience
Minimum 10 years’ progressively responsible experience in contracting and/or provider network systems
Minimum 4 years’ supervisory experience
Management experience in a managed care organization or practice setting
Value based contracting experience
Provider relations experience
In addition to satisfying work, our staff enjoys a competitive benefits package, including:
– A culture that values collaborative, innovative work.
– Competitive pay and comprehensive benefits.
– Flexible work schedules.
– Telecommuting options for many positions.
– Subsidy for wellness activities.
– A 401K program with generous employer contributions.
– Training and education opportunities.
– Sabbatical Leave Program.
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