Lumeris Chief Medical Officer - Regional Operations in San Antonio, Texas
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Chief Medical Officer - Regional Operations
The Chief Medical Officer (CMO), Regional Operations, serves as the executive clinical lead for Lumeris’ unique Population Health Services Organization (PHSO) operating partnerships with Health Systems and Physicians. The CMO collaborates across a matrixed entrepreneurial culture to provide clinical and population health management expertise and leadership, with a specific focus on Physician leadership/engagement, clinical practice transformation and care delivery model design and execution.
Role and Responsibilities
Provide clinical leadership in the development, organization and leadership of a clinically integrated network (CIN) of physicians.
Participate in business development meetings with prospective clients to present the Lumeris value proposition.
Strategize with the Corporate Chief Medical Officer (CCMO) on clinical strategy, design and approach, facilitating communications, and managing risk on active engagements.
Maintain strong relationships with CIN Medical Directors and clinical leaders at client organizations.
Act as an internal consultant on clinical program development and special projects for Lumeris customers.
Participate in ongoing product development activities related to Lumeris technologies and services.
Provide timely, proactive communications and progress reports to the CCMO and other key stakeholders regarding Lumeris activities and external client status.
Provide support to the Accountable Delivery Systems Institute as needed on matters relating to accountable care, physician engagement/alignment, payer and clinical transformation, and the use of leading technology in support of the new models of care.
Direct and monitor medical management activities and quality management programs as needed to maintain compliance with CMS and other accrediting bodies.
Experience, Qualifications, and Education
MD. or D.O. degree, plus Board Certification. Current, unrestricted medical licensed.
Minimum of five years successful clinical practice experience.
Minimum of three years health plan or capitated provider experience with exposure to: disease management, HEDIS reporting, provider relations, utilization management, quality management, peer review, case management, denial/appeals, and accreditation.
Prior operational consulting experience a plus.
Knowledge of healthcare financing and the relation to various managed care products (HMO, PPO, Indemnity, and Medicare Advantage).
Government sector experience a plus (Medicare or Medicaid products).
Knowledge of continuous quality improvement theory and practice.
Excellent communication and problem-solving skills.
Demonstrated track record of building productive working relationships with subordinates, peers, senior management, and external customers.
High level of energy and drive.
Flexible personality; easily adaptable to change/ambiguity.
Domestic travel required (approximately 35 percent).
Candidate will primarily serve clients in the Southwest U.S. and will make regular trips to the headquarters in St. Louis, MO.
Lumeris is an EEO/AA employer M/F/V/D.
San Antonio, TX
1 - FT
Join Our Growing Team!
Lumeris serves as a long-term operating partner for organizations that are committed to the transition from volume- to value-based care and delivering extraordinary clinical and financial outcomes. Lumeris enables clients to profitably achieve greater results through proven playbooks based on collaboration, transparent data and innovative engagement methodologies. Lumeris offers comprehensive services for managing all types of populations, including launching new Medicare Advantage Health Plans, Commercial and Government Health Plan Optimization, and Multi-Payer, Multi-Population Health Services Organizations (PHSOs). Currently, Lumeris is engaged with health systems, provider alliances and payers representing tens of millions of lives moving to value-based care.
Over the past seven years, we have tripled in size to more than 800 employees and built the only solution on the market with our proven outcomes. For the past six years, Essence Healthcare, a long-standing Lumeris client, has received 4.5 Stars or higher from the Centers for Medicare and Medicaid Services (CMS). Essence Healthcare was Lumeris’ pioneer client and has been leveraging Lumeris for more than a decade to operate its Medicare Advantage plans, which serve more than 60,000 Medicare beneficiaries in various counties throughout Missouri and southern Illinois.
In 2018, Lumeris was named Best in KLAS for Value-Based Care Managed Services in the area of client-reported impact on the Triple Aim by KLAS Research. This was the third year in a row Lumeris received the award, and it has only been given for three years. As the industry’s most reliable and effective partner for developing population health management solutions, our success is driving tremendous growth in our company. Join us today in making a real difference in how healthcare is delivered!
Why Join Lumeris?
At Lumeris, you will be part of team that is focused on solving the nation’s healthcare problem, and you will be able to contribute to our purpose. Our environment is fast-paced, change-oriented and focused on growth and employee engagement. At Lumeris, we know that talent is best utilized when given the opportunity to succeed. That is why we have removed the boundaries that inhibit success and focus on fostering an environment that allows employees to utilize their talents.