The Chief Medical Officer (CMO) is responsible for improving the standard of care within the GRIPA network. This includes developing and promoting value-based care initiatives, programs, and strategies aimed at improving healthcare quality, patient outcomes, patient satisfaction, and cost efficiency. The ideal candidate will possess strong leadership skills, extensive clinical experience, and an understanding of value-based care models and reimbursement systems. The CMO will ensure the GRIPA providers have the tools needed to be successful in accountable care and value-based care programs by interfacing with physicians, the health system, and other stakeholders.

Objectives:

• Identify and prioritize quality improvement opportunities by analyzing healthcare data, clinical guidelines, and evidence-based practices.
• Develop and oversee quality improvement programs to optimize patient outcomes and drive performance improvement.
• Monitor the quality performance of the network and provide timely and constructive feedback to providers.
• Engage and collaborate with various stakeholders, including physicians, administrators, payers, and community partners, to drive the adoption of value-based care principles and ensure effective care coordination across the continuum.
• Provide guidance, education, and support to physicians and clinical staff on value-based care principles, clinical best practices, and compliance requirements.
• Foster a culture of continuous learning and improvement within the organization.
• Monitor quality performance, identify opportunities for cost savings and implement strategies to optimize outcomes.
• Stay abreast of relevant healthcare regulations, policies, and guidelines.
• Remain informed about emerging trends, innovations, and best practices in value-based care models.
• Serve as GRIPA’s liaison to the participating providers in regards to medical management.
• Provide leadership to the Rochester Regional Physician Organization to ensure cooperation between organizations and consistency in operating policies, procedures, and practices.

Job Responsibilities:

Utilizing input from GRIPA leadership, health system leadership, clinical leaders, members of the medical staffs, the Chief Medical Officer will:

• Complete routine visits with all participating GRIPA providers in their offices on a rotating basis to ensure maximum communication with our network.
• Serve as Chair for the GRIPA Clinical Integration Committee and the Advisor/Facilitator for the Advisory Committees.
• Ensure that the Clinical Integration committees are adequately and appropriately structured for their functions and that the committees effectively perform their functions.
• Establish and ensure adherence to policies and workflows in an effort to continually provide the highest quality of care, at the appropriate cost effective setting.
• Ensure the objectives of accountable care, value-based care, and clinical integration program are met – aligning high quality, patient satisfaction, and cost value.
• Build initiatives within the accountable care, value-based care, and clinical integration program which demonstrate financial benefit to participating physicians, shareholders, and contracted payors.
• Interact with Rochester Regional Health, community agencies, healthcare partners, and payors to support and facilitate the growth of our network, including primary care providers.
• Participate in the development and application of credentialing procedures for members of the GRIPA and the Rochester Regional Health PPO, Inc. and ensure that the companies continue to meet credentialing requirements for certification by NCQA.
• Attend and contribute to discussions at monthly Credentialing Committee meetings and create summaries for approval by the GRIPA Board of Directors.
• Support the organization’s work to comply with legal and regulatory requirements.
• Review and contribute to the development of policies and procedures.
• Offer medical leadership for the development, implementation and management of quality programs, cost management initiatives, and health promotion for managed care.
• Support related work for Rochester Regional Health by contributing to value-added programs, referral review for out of network requests, appropriate sizing and geographic distribution of network, and benefit plan design.
• Monitor utilization and consult with providers regarding appropriate utilization of medical services, providing information and data as needed.
• Provide medical review and response to complaints and claim adjudication when requested.
• Oversee GRIPA’s Care Management Services team to support the best care of contracted patients.
  • Review and participate in the development of assessment and care planning tools and procedures;
  • Provide input and medical review in the development of policies and procedures for care management services;
  • Ensure appropriate care planning in collaboration with primary care physicians and physician specialists;
  • Lead and consult in the development of care protocols when needed;
  • Identify opportunity and direct the development of disease management programs for chronic illnesses.
• Oversee GRIPA’s Provider Relations team to support their outreach and communication to GRIPA provider practices related to all GRIPA initiatives.
• Participate in performance review of staff as appropriate and requested.
• Contribute thought leadership to internal and external projects.
• Support all GRIPA service offerings from a clinical knowledge perspective.
• Participate on health related leadership committees across the community as appropriate.
• Other administrative functions not directly related to clinical programs as needed to support GRIPA and its stakeholders.

Requirements:

• Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO) degree from an accredited institution.
• Minimum of 10 years of clinical experience.
• Leadership experience within clinical practices, committees, or governance structures.
• Working knowledge and experience participating in value based care programs.
• Excellent verbal and written communication skills.
• Ability to prioritize and work with a team.
• Demonstrate flexibility and a willingness to take on new challenges as the organization grows.
• Standard vaccine requirement:
  • As an affiliate of Rochester Regional Health, GRIPA|Cognisight requires employees who reside in New York State to be vaccinated against COVID-19. If you reside in New York State, you will be required to provide proof of vaccination upon hire or upon establishment of residency in New York.

If interested, please forward your cover letter and resume to alexandra.coykendall@rochesterregional.org

EQUAL OPPORTUNITY EMPLOYER. GRIPA and Cognisight, LLC is an Equal Opportunity Employer and does not discriminate against any person because of race, creed, color, religion, national origin, age, sex, sexual orientation, gender identity, genetic information, protected veteran status, or disability.

PHYSICAL REQUIREMENTS: S - Sedentary Work - Exerting up to 10 pounds of force occasionally Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.