Description

Take on a key clinical leadership role within a dynamic health organization. Help drive the delivery of high-quality, cost-effective care for Medicare Advantage members. Take your expertise to new levels. You can do all this and more at New Century Health Plan.

Reporting to the Chief Medical Officer, you will play a pivotal role in leading clinical efforts to optimize care delivery and outcomes for Medicare Advantage members. You will:

• Provide clinical leadership and oversight to ensure the highest standards of care and cost-effectiveness

• Manage utilization and case management activities to drive efficiency and quality

• Oversee appeals, grievances, and potential quality issues (PQI)

• Develop and implement clinical strategies to improve health outcomes and ensure compliance with regulatory requirements

• Collaborate with senior leaders to enhance the overall performance of the Medicare Advantage Plan

Salary Range: $142,100- $348,100/annuallyQualifications

We're seeking a dedicated and experienced clinical leader

with:

• MD or DO degree from an accredited medical school

• Board certification in a primary care specialty (Internal Medicine, Family Medicine, Geriatrics)

• Valid and unrestricted medical license in California

• Advanced degree in healthcare management or related field, highly desired

• 3 or more years of clinical practice experience

• 2 years or more years of Medicare Advantage management experience

• Experience in a health plan or large healthcare organization, preferred

• Strong knowledge of Medicare regulations and CMS guidelines

• Excellent analytical, problem-solving, and decision-making skills

• Strong communication and interpersonal abilities

• Proven leadership abilities that demonstrate openness to change and a capacity for implementing creative programs that support strategic initiatives

• Strong analytical, organizational, and project management skills

• Proficiency in Microsoft Office applications (Word, Excel, PowerPoint)

UCLA Health welcomes all individuals, without regard to race, sex, sexual orientation, gender identity, religion, national origin or disabilities, and we proudly look to each person’s unique achievements and experiences to further set us apart.