Careers With Purpose
Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint.
Facility: GSS National Campus
Location: Sioux Falls, SD
Address: 4800 W 57th St, Sioux Falls, SD 57108, USA
Shift: 8 Hours - Day Shifts
Job Schedule: Full time
Weekly Hours: 40.00
Department Details
Sanford Health’s executive leadership is based in Sioux Falls, South Dakota. A vibrant, strategically located city that reflects the values of our organization. Relocation to Sioux Falls is required for all C-suite roles, reinforcing our commitment to servant leadership and meaningful community engagement. As a premier rural health care organization, Sanford Health is dedicated to advancing innovation and excellence in partnership with the communities we serve.
Job Summary
The Chief Medical Officer is responsible for providing medical oversight, expertise and leadership to ensure the delivery of cost effective, quality healthcare services to health plan members. Reporting to the President and CEO of the health plan and collaborating with the senior leadership team within the plan and the system, the Chief Medical Officer will lead and directly manage the health plan’s key clinical teams and utilization review processes. Manages and leads Health Plan's medical directors, pharmacy team, and clinical operations team which includes utilization management, care management, population health, quality, risk adjustment and appeals and grievances.
Serves as clinical advisor to and educator of medical management staff making sure correct clinical judgment is applied to all medical management determinations. Provide leadership and expertise in the development, implementation and interpretation of medical review and quality related policies and guidelines.
Coordinate physician input and efforts to develop and coordinate clinical pathways, practice patterns, protocols and health insurance plans. Promote positive relations with the local medical community, including periodic consultation with providers or prescribers. Review case management data, identifies trends and gaps in care and recommends corrective actions. Review all quality of care issues and oversees the development and implementation of processes for improvement.
Participate in and provide clinical expertise in data collection and analysis to achieve high-quality services and cost efficiency. Monitor performance indicators to ensure the delivery of cost-effective care within quality standards. Applies advanced technical knowledge of clinical medicine and the medical insurance industry to solve highly complex challenges.
Ensure the delivery of safe, high-quality health care in accordance with enterprise mission, vision and strategic goals.
Qualifications
Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO) required. Master's degree in business administration, population health, public health, or health care economics preferred.
Minimum of three years of health plan/insurance experience preferred. Rural experience preferred.
Must be licensed (or obtain license) to practice medicine in South Dakota or Wisconsin.
Benefits
Sanford Health offers an attractive benefits package for qualifying full-time and part-time employees. Depending on eligibility, a variety of benefits include health insurance, dental insurance, vision insurance, life insurance, a 401(k) retirement plan, work/life balance benefits, and a generous time off package to maintain a healthy home-work balance. For more information about Total Rewards, visit .
Sanford is an EEO/AA Employer M/F/Disability/Vet. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-877-673-0854 or send an email to [email protected] .
Sanford Health has a Drug Free Workplace Policy. An accepted offer will require a drug screen and pre-employment background screening as a condition of employment.
Req Number: R-0214043
Job Function: Leadership
Featured: No
COMPANY PROFILEGreat Minds, a mission driven Public Benefit Corporation, brings teachers and scholars together to craft exemplary... ...capabilities of students.Job PurposeThe Vice President of Corporate Communications will lead external and internal communications planning and...
...POSITION: ROAD MAINTENANCE WORKER STARTING PAY: $21.13 hour (Minimum Starting Wage) JOB SUMMARY Perform a variety of semi-... ...UDOT guidelines. Knowledge of mechanical applications; road construction methods and techniques; work zone regulations. Skill in operating...
...Call The Bee , part of the renowned Apex Service Partners network, has an exciting... ...Consultant . We are looking for a driven and customer-focused professional to help homeowners find... ...Consultations - Visit customers' homes and provide professional consultations for...
...opportunity so you can grow your career and expand your skills in the long term. Forming part of the Biotechnology segment at Danaher, we bring together dedicated technical expertise and talent to develop the next generation of life-changing therapeutics. This position...
Overview: Wilmington Treatment Center has an opportunity to hire a Substance Abuse Counselor to join their Amazing Team! As a Substance Abuse Counselor you will provide treatment and support to assist patients in their recovery from addictions, such as alcoholism...