Chief Medical Officer- MDLive- Evernorth

Location: Willing to consider any Cigna onsite location in the U.S.

OVERVIEW: The CMO for MDLive will report to the Vice President of Clinical and Operations for MDLive. The CMO will oversee clinical operations and ensure clinical quality, patient safety, provider satisfaction, risk management, operational excellence, and financial success. The role involves clinical leadership, product strategy input, and scaling medical leadership.

RESPONSIBILITIES:

Support the President and MDLIVE senior leadership team in achieving financial and operational targets consistent with MDLIVE’s 3-5-year plan.

• Ensure stability of unit economics by maintaining appropriate visit metrics and significantly reducing cost per visit.

• Own and continuously improve/update the clinical model for all programs for competitiveness, quality, efficiency and affordability.

• Provide clinical leadership of the MDLIVE physician network, medical staff and programs throughout MDLIVE including overseeing appropriate number and type of medical directors.

• Partner with Product Leaders to provide input & guidance into product roadmap from a clinical standpoint.

Ensure the highest quality of clinical care.

• Leverage physician scorecards to drive IHI “Triple Aim” continuous quality improvement, conducing monthly individual evaluations against the following metrics: antibiotic rates, credentialing/licensing/training, patient satisfaction and coverage/scheduling adherence.

• Consistently meet patient satisfaction/NPS score goals.

• Provide ongoing specialized training in communication and diagnosing patients over the phone and through online video to all employed and network physicians.

• Work with the Chief Operations Officer to establish and maintain an in-sourced physician credentialing process.

• Adhere to established HIPAA, NCQA, URAC and any other applicable guidelines and ensure program outcomes are available to meet these standards and clinical quality measures and able to demonstrate MDLIVE’s value proposition.

• Ensure provider community complies with all local, State, Federal and other regulatory requirements as well as nationally recognized standards of care.

• Ensure products and services provided by the company are compliant with required regulations.

• Continually stay abreast of compliance developments in the healthcare and telehealth space and update internal procedures, policies and documentation accordingly.

• Act as the owner of all patient safety related matters.

• Prepare reports for and escalate relevant matters to the Compliance and Quality Committee of the Board.

Build an engaged provider community, both employed and with a network of physicians which increases efficiency in delivery of care.

• Grow the preferred and committed provider network by building strong relationships with the providers.

• Continually optimize per visit economics by growing provider network.

• Build in services and processes to make the provider visit more efficient (improving patient intake, reducing average visit time).

• Capture provider-level cost savings by optimizing physician model (i.e. right levels of employed vs. contractual providers).

• Support development of a Value-Based Care strategy, incorporating areas such as: lab testing, clinical service lines specialty pharmacy, chronic care management.

• Work with product team to drive prioritization and design of physician portal requirements.

Continuously improve consumer and provider experience when using the MDLIVE platform.

• Assist with analytics-driven improvements to platform, including additional automation and enhanced service offerings, working with payors to ensure a seamless consumer and provider UX.

• Improve provider experience by optimizing volume, quality, efficiency, incentives and overall satisfaction.

• Improve the patient experience by optimizing access, quality and satisfaction.

• Improve the client experience by optimizing quality, costs/ROI, and satisfaction.

Ensure MDLIVE has the quality and depth of medical talent required to successfully scale.

• Define the organizational structure that will best support attainment of strategic and financial goals, and ensure there is the right financial and operating discipline in the business.

• Ensure the organization has the right capabilities to improve operations as they exist today. Work creatively and collaboratively with large enterprise customers and drive direct-to-consumer satisfaction.

• Build forward-looking scorecards for each key/leadership role, evaluate the current team and either select the leaders which best fit the scorecard or seek external candidates.

• Align incentive compensation plans with strategic goals of the company.

• Ensure skills and capabilities are being transferred to other employees in the organization to build leverage.

• Develop a succession plan.

• Own and continuously improve/update the clinical model for all programs for competitiveness, quality, efficiency, and affordability.

• Provide clinical leadership of the MDLIVE physician network, medical staff and programs throughout MDLIVE, including overseeing appropriate number and type of medical directors.

• Improve provider experience by optimizing Volume, Quality, Efficiency, Incentives and overall Satisfaction.

• Improve the patient experience by optimizing Access, Quality, and Satisfaction.

• Improve the Client experience by optimizing Quality, Costs/ROI, and Satisfaction.

• Ensure that program outcomes are available to meet NCQA, URAC and Star clinical quality measures and demonstrate our value proposition.

• Collaborate with MDLIVE marketing and sales to support promotion and sales of our products and services.

• Collaborate with Finance, IT and clinical analytics to understand, develop, implement, and evaluate programs to improve quality and cost outcomes, as well as drive product and service improvements and innovations.

• Help create and support Industry partnerships and relationships with Payors, Employers, Healthcare Systems, Pharmacies, PBMs; EMR and other HIT vendors; Government, including Policy and Regulatory agencies; Investors, Media and appropriate associations, organizations and networks.

• Provide Thought Leadership and Networking via developing the company’s internal and external vision, and communicating via blogs, articles, interviews and speaking opportunities. Provide representation at industry events, such as ATA, HIMSS, AMDIS, and other related conferences.

• Actively engage with President and Legal and Compliance/Regulatory Affairs in order to ensure CMS and other regulatory compliance, while also providing proactive advocacy and relationship strategy with CMS leadership, program directors, and other policymakers to help improve the regulatory landscape.

• Provide representation at industry events such as ATA, HIMSS, AMDIS and other related healthcare conferences.

REQUIRED SKILLS:

• Active/unrestricted MD or DO.

• Board Certified in an ABMS clinical specialty.

• 10+ years of direct hands on clinical work.

• Leadership/direction of a large medical group and/or national healthcare organization (IPA, PHO, MSO or Foundation).

• MBA or related business experience is preferred.

• Highly analytical and data-oriented with the ability to work with large sets of data and identify trends to enhance business decision-making.

• Prior experience managing complex clinical operations and driving process and cost improvements.

• Proven track record influencing large health care organizations.

• Possess advanced level of complex matrix leadership competencies.

• Maintain current clinical knowledge.

• High level of integrity and ability to proactively identify and communicate gaps.

• Up to 50% (employee, partner and client meetings, conferences and other meetings and events).

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

About Evernorth Health Services

Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application process, please email: [email protected] for support. Do not email [email protected] for an update on your application or to provide your resume as you will not receive a response.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.