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Deputy Chief Medical Officer

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MetroPlus Health PlanNew York, NY
Full-time
  • About NYC Health + Hospitals
  • MetroPlus Health Plan provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc.
  • As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlus’ network includes over 27,000 primary care providers, specialists and participating clinics.
  • For more than 30 years, MetroPlus has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.
  • Reporting to the Chief Medical Officer, the Deputy Chief Medical Officer helps to play a critical role in managing the health plan’s Medical Management operations, including: care management, long term care, children’s medical services and the integration and innovation of physical health and behavioral services for high risk members.
  • The Deputy Chief Medical Officer serves in policy, operational and strategic capacities and helps lead health informatics function to prioritize activities for the Plan’s Disease and Case Management in-house platform.
  • The Deputy Chief Medical Officer will also provide weekly support for the Plan’s Utilization Management department.
  • This is a broad function that includes day to day operations, data and reporting design and high-level strategy, planning and policy involvement.
  • Enhances the health informatics function and assures decisions are made according to data insights.
  • Leads new projects and initiatives.
  • Assists in new technology assessment and clinical policy review as required
  • Responsible for overseeing implementation of ongoing changes in policy and procedures from State and Government entities.
  • Participates in the development of strategic planning for existing and expanding lines of business.
  • Represents the health plan at regulatory meetings held by the New York State Department of Health, and managed care trade organizational meetings as necessary.
  • Develops VBP strategies
  • Fosters relationships with the Delivery System
  • Reviews cases, determines medical necessity, and consults with physicians.
  • Provides clinical support for Utilization Management on a weekly basis.
  • Performs other duties as needed and assigned by the Chief Medical Officer
  • Doctor of Medicine or Doctor of Osteopathic Medicine degree from an accredited and approved school of medicine.
  • A minimum of three (3) years of clinical experience post residency
  • A minimum of seven (7) years of experience in a Managed Care setting.
  • Proven experience with heath informatics/data sciences
  • Minimum five (5) years of management experience
  • Licensure and/or Certification Required
  • Valid and current license to practice medicine in the state of New York.
  • Board Certification in one of the following: Internal Medicine, Preventive Medicine, Family Medicine
  • Integrity and Trust

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