Buscar empleo: 178 ofertas de trabajo de medical review physician en Camden, New Jersey (mayo 2026) - page 2

Chief Medical Officer, CMO - PACE (Remote)

hace 1 día

Philadelphia

Employment Type: Full time Shift: Description: This position is "remote" and will require travel within the PACE Centers geographic region and to home office in Livonia, MI. Trinity Health is one of the largest continuing care organizations in the country, providing a full range of services to support seniors at every stage of life. Through our three national organizations offering home health, hospice, PACE and senior communities, we create vibrant living environments and deliver high-quality, compassionate care tailored to individual needs. PACE offers seniors the option to live independently at home, while receiving the high-quality care and support they need to thrive at our PACE centers. Our approach fosters holistic wellness, addressing medical needs while enriching lives through services tailored to each participant's needs. We have 14 programs across 12 states, 26 centers with over 1000 colleagues and more than 3000 participants. POSITION PURPOSE The primary purpose of the Chief Medical Officer for PACE is to provide clinical leadership and oversight of all owned PACE programs as well as being available for clinical consultation with the managed programs. Responsible for clinical/medical input into strategic and operational discussions. Able to collaborate with a variety of system-level leaders in the departments of Finance, Quality, Compliance, Informatics, Coding, Claims adjudication, Education, Credentialing and Operations. Acts as an external-facing position to enhance Trinity Health's exposure and medical presence in the communities we serve. Disclaimer: The following statements are intended to describe the general nature and level of work assigned to this position. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of the individual in this position. Other duties may be assigned as deemed necessary or appropriate by management. LEADERSHIP COMPETENCIES As a Trinity Health Executive, the incumbent is expected to demonstrate leadership traits which support our Mission Statement and Core Values as identified below: Mission Statement: We, Trinity Health, serve together in the spirit of the Gospel as a compassionate and transforming healing presence within our communities. Core Values: * Reverence: We honor the sacredness and dignity of every person. * Commitment to Those Experiencing Poverty: We stand with and serve those who are experiencing poverty, especially those most vulnerable. * Justice: We foster right relationships to promote the common good, including sustainability of Earth. * Stewardship: We honor our heritage and hold ourselves accountable for the human, financial and natural resources entrusted to our care. * Integrity: We are faithful to those we say we are. * Safety: We embrace a culture that prevents harm and nurtures a healing, safe environment for all. Vision As a mission-driven, innovative health organization, we will become a leader in improving the health of our communities and each person we serve. We will be the most trusted partner for life. Promise Statement We Listen. We Partner. We Make it Easy. Our Actions Listen to understand. Learn continuously. Keep it simple. Create solutions. Deliver outstanding service. Own and speak up for safety. Expect, embrace and initiate change. Demonstrate exceptional teamwork. Trust and assume goodness of intentions. Hold myself and others accountable for results. Communicate directly with respect and honesty. Serve every person with empathy, dignity and compassion. Champion health equity and the common good ESSENTIAL FUNCTIONS * Know, understand, incorporate, and demonstrate the Mission, Vision, Values and Guiding Behaviors of Trinity Health and Trinity Health PACE (TH PACE) in behaviors, practices, and decisions. * Consistently demonstrate (leads by example) TH PACE Values to all internal and external customers (participants, visitors, volunteers, and colleagues). Create and maintain an atmosphere of warmth, propagating a calm environment throughout the office. * Execute assignments in a culture that is shared and collaborative across all divisions within TH PACE. * Reflects the skills knowledge and abilities serving in the role of a leader. Define and share a strategy and vision; align resources toward achievement of organization results; grow and sustain the organization; identify, lead, and embrace change. * Establish and/or maintain, as a member of the leadership team, a plan to achieve operating goals. * Promote and maintain collaborative relationships with managers, peers, direct reports and customers by effectively fostering a team environment, building consensus and resolving conflicts. * Identify financial vulnerabilities and make cost containment and reduction recommendations as needed. * Evaluate, develop, mentor, coach, counsel and discipline department staff. Supports colleagues from other departments through coaching and mentoring to help achieve the optimum standard of excellence. Addresses issues of concern through courageous conversation and notifies the department manager of any interactions requiring attention. * Maintains a working knowledge of applicable Federal, State, and local laws and regulations, TH PACE Corporate Integrity Program, Code of Ethics, as well as other policies and procedures to ensure adherence in a manner that reflects honest, ethical and professional behavior. * In light of a disaster will know your disaster recovery, crisis management and business continuity plans and act within your role that is developed within the business continuity plan. This may include working at another location, remotely from home, and maintaining constant contact with key personnel. * Serve as a member of Trinity Health PACE Executive Leadership Team and be actively engaged in strategic and operating plan development. * Communicate with Pharmacy Benefit Manager and pharmacy provider(s) as necessary to ensure high quality clinical care and standardization of pharmacy practices and decisions. * Participate in Part D audits and development of corrective action plans. * In collaboration with the TH PACE Clinical Pharmacist, review Milliman FWA reports as well as drug utilization reports to identify trends, observations and performance improvement plans for TH PACE as well various local Pos. * Collaborate with Chief Nursing Officer (CNO) on creation of policies/procedures for corporate level clinical initiatives which include but is not limited to: Controlled Substance Use, End of Life Procedures, Medication Administration, Care Management Duties/expectations, Telehealth initiatives, and Provider Documentation. * Responsible for reviewing Utilization Reports and claims data to identify trends and adverse utilization patterns. Review information with local program Medical Director(s) (MD)/ and identify and monitor utilization performance improvement plans as indicated. Establish expectations for Utilization Management (UM) meetings involving regular, structured sessions that focused on data review, policy updates, resource efficiency (over/underutilization), and improving patient care, ensuring clear roles, documented actions, and accountability for quality & cost containment. * Educate, mentor and coach new and existing MDs at local PACE Organizations (PO). * Actively engage in the development and implementation of the Quality Improvement and Performance Improvement process at the local POs, provides for the functioning and effectiveness of quality improvement systems and initiatives to include, but not be excluded to, internal and external operating systems that affect the delivery of care at local POs., Works in collaboration with TH PACE and local PO Quality and Improvement colleagues to ensure effective quality improvement systems and strategies are in place. Sets expectations for local MDs to oversee and actively participate in the local QI programs. * Ensures continuity of medical care at local Pos. In the absence of a local PO MD, may be required to obtain state-specific licensure and assume MD responsibilities until a replacement is identified. * Establishes a universal standard for the delivery of participant care across all TH PACE POs. Is the leader in the setting of physician and nurse practitioner goals and improvement plans for POs. Uses data to compare program performance to other POs. * Leads recruitment, interviews and orientation of new Primary Care Providers across all owned POs. Work in conjunction with HR to obtaining locums providers, when needed. * Develops relationships with local organizations, medical practices, and universities to encourage educational opportunities and provider recruitment. Participate in evaluating new providers for clinical contracting. * Collaborate with Director of Education for Education Affiliation Agreements for medical students, residents and geriatric fellows to engage in activities within the centers. * Act as Activity Director for all IPCE courses. * Participates in the CORE committee, managing educational and research projects in collaboration with the Director of Education. * Provides leadership development opportunities and sets goals and objectives for the development of key medical staff for POs. Acts as a role model for primary care providers and creates opportunities for provider understanding of business and strategic operations at the local PO. * Provide executive leadership over the development and/or implementation of standardized clinical policies and procedures to guide clinical operations. Ensures policies and procedures support the strategic clinical objectives of the TH PACE POs. * Work directly with TH PACE CNO in bridging the clinical arena of the PO to the development of TH PACE standards of performance and TH PACE policy. * Lead and facilitate Medical Directors Council for purposes of shared learning and best practice development opportunities. * Collaborating with the Vice President, Operations about multiple issues, including but not limited to: * Provider performance, behavior and recruiting * Utilization of services, inpatient and outpatient * Enrollment processes surrounding obtaining records before enrollment * Policy standardization * Establish and oversee provider onboarding and training programs and practices. * Participate in evaluating, selecting and integrating health care technology and information systems that support member care. Enforce compliant optimization of the EMR by the Primary Care Team and reinforce appropriate practices related to clinical records and documentation. * In collaboration with the CNO, create and monitor disease management processes and protocols. * In collaboration with the compliance leader, ensure all local POs maintain compliance with credentialing practices. * Serve as ad hoc Chair for Credentialing Committee reviewing and if appropriate, approving new provider credentialing documents. * In collaboration with the CNO, responsible for the standardization of clinical staffing ratios. Instructions on coding and documentation for providers, in conjunction with the Director of Coding * Maintain professional growth and development. Remains up to date on changing trends in geriatric health care. MINIMUM QUALIFICATIONS * Graduate from an accredited medical school and completed an accredited residency program in a medical specialty. Current and active plenary physician license to practice. * Board certification in field of specialty and agree to maintain such Board Certification through tenure of employment. * AMDA certification and/or ABIM certification in geriatrics preferred. * Proven leader with minimum of five (5) years in clinical practice, minimum five (5) years of leadership experience. and 3 to 5 years of PACE experience * Ability to work in a complex matrix reporting environment. * Must be action-oriented, have business acumen, manage conflict well, be customer focused, have high decision quality, flexibility to adapt to ongoing change and have organizational agility. Ability to work with minimal supervision and exercise independent judgment. * Possess interpersonal skills to drive collaboration, commitment and productivity when working with cross-functional teams, customers and end users. Must be comfortable functioning in a virtual, collaborative shared leadership environment. * Demonstrates superior written and verbal communication and presentation skills appropriate for audience comprehension. Well-developed communication skills, both written and oral, that may be used either in an on-site or virtual environment is required. Able to communicate effectively with individuals and groups representing diverse perspectives. * Comprehensive to expert proficiency with Microsoft product suite (MS Word, Excel, Power Point, etc.); basic knowledge and experience with electronic mail and calendaring system. Knowledge of systems necessary, experience preferred. Ability to type with speed and accuracy. Ability to use other software as required to perform the essential functions of the job. * Possesses a high degree of personal accountability, responsibility and independent decision-making abilities with the skills to plan, organize, develop, implement and interpret programs, goals, objectives, policies and procedures of the organization in line with mission, vision, and philosophy of TH PACE. * Excellent organizational skills. Ability to perform multiple duties and functions related to daily operations and maintain excellent customer service skills. Ability to perform frequent detailed tasks and provide immediate service with frequent interruptions. Ability to change and be flexible with work priorities. Strong problem-solving skills. * Ability to research, analyze and assimilate information from various on-site or virtual sources based on technical and experience-based knowledge. Must exhibit critical thinking skills and possess the ability to prioritize workload. * Position requires 20% - 50% travel within the PACE Centers geographic region and to home office in Livonia, MI. Our Commitment Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law. Our Commitment to Diversity and Inclusion Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions. Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity. EOE including disability/veteran

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