The Market Medical Executive (MME) is the senior medical director for Cigna Medicare in the Florida market and is a member of the Florida market’s Senior Leadership Team (SLT). The MME will report to the Regional Medical Executive and is responsible for the achievement of total medical cost competitiveness and for driving key business, clinical and quality initiatives through collaborative interactions with healthcare provider partners, health systems and key internal partners.
- Works with the finance and informatics teams to develop analytics and reports that identify opportunities and monitor program success.
- Clinical thought leader in providing solutions for improvement in total medical costs while assuring appropriate balance between clinical quality and medical costs, operational efficiency, and service to internal and external customers and providers.
- Engages with our clinical operations utilization management and case management teams for tactical strategy and continuous improvement in our efforts to deliver high quality affordable health care.
- Improve clinical outcomes through interactions with health care professionals using active listening, excellent communication and negotiation skills.
- Participates in utilization management, when necessary, for the Florida market, including precertification, concurrent review and appeals.
- Supports growth through strategic collaboration with the Florida Market President and the Market President’s SLT to achieve sales and growth goals.
- Collaborates with providers and health systems engaged in quality-based incentive programs that are in-line with Cigna’s Medicare Business quality initiatives to help achieve outstanding performance.
- Serves as market clinical representative in provider community, drives provider feedback back into the organization and insures clinical quality and integrity achieve high standards.
- Knowledge of managed care products and strategies
- Current board certification in an ABMS or AOA recognized specialty
- Ability to work within a rapidly changing, fast-paced matrix environment
- Active and unrestricted FL Medical License
- Fluent in English and Spanish languages
- Demonstrated sensitivity to culturally diverse situations, participants, and customers
- Possesses strong and effective teamwork, negotiation, conflict management, decision-making, analytical and problem solving skills
Qualification & Experience:
- Minimum 3 years of experience in medical management, case management in a managed care setting or in physician leadership roles
- Minimum 5 years of clinical practice experience
- Demonstrated ability to educate peers, colleagues and staff members in a collegial manner
- Degree in medicine from an accredited school (MD or DO)
Vacancy Type: Full Time
Job Functions: Other
Job Location: Doral, FL, US
Application Deadline: N/A