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Chief Medical Officer And Regional Medical Director Resume Example

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Jessica Claire
Montgomery Street, San Francisco, CA 94105
Home: (555) 432-1000 - Cell: - resumesample@example.com - -
Executive Profile

The physician is an accomplished executive with a demonstrated ability to deliver mission-critical results.He is an executive with solid experience managing multiple projects including budgeting , quality improvement, practitioner management and administration. The executive has critical knowledge of special population management and population analysis. Experience working with contracting, sales, compliance , customer service, and benefit design personnel. The executive has a knowledge of quality measurements, and interpretation. Experience working with RAF and HEDIS measures. He has developed value-based programs with quality outcomes for providers and with centers of medical excellence.

Skill Highlights
  • Leadership/communication skills
  • Background in Medical Quality Process
  • Strategic objective execution
  • Physician Leadership and Management/Psychiatric Project management
  • Product line expansion
  • Management with a talent for product line development/Medical Staff credentialing/evaluation of physician impairment/ fitness for duty/treatment and planning for Seriously Mentally-ill populations/Behavioral Risk Management
  • Policy Development for Hospitals/outpatient clinics
  • Expertise in cultural psychiatry, sexual behaviors, psychiatric administration,fitness-for- duty, treatment of the seriously mentally-ill, treatment of adolescents/ adults, and assessment of workplace violence
  • Board Certified in Adult psychiatry/Forensic Psychiatry/ Psychiatric Management and Administration and Quality Management.
  • Expertise in dispute resolution within organizations
  • Former SVP of Workplace Violence for the Isaac Ray Center, Chicago,Ill and
  • Former Medical Director Northwest Community, Youth Network, Arlington Heights, Ill.
  • Former Forensic Coordinator for Montgomery County of Penn.
  • Former Chief Medical Officer, Friends Hospital, Philadelphia, Pa.
  • Former Chief Medical Officer, Arizona Department of Behavioral Health
  • Full Professor of Psychiatry, Creighton University at Phoenix.
  • CMO, Health Net of Arizona
  • Leadership
  • Communication skills
  • Vendor negotiations
  • Interpersonal skills
  • Market analysis
  • Matrix management
  • New Business development
  • Community outreach
  • Mentoring and mediation skills
  • Customer relations
  • Medical and Behavioral health management skills
Core Accomplishments

Experience as Chief Medical Officer within a medical health plan, hospital system and within a state agency

Experienced manager for physicians and non-physicians

Chair experience with pharmacy , peer review, quality, medical utilization and appeals

Board certified with in psychiatry, forensic psychiatry by the ABPN, administration and management by the APA ,quality management and utilization management by the ABQAURP.

Experienced in Arizona Community Outreach strategies

Experience integrating behavioral health and medical practice incentives

Management of Medical Management transactions services(i.e.,prior authorizations,concurrent reviews, appeals, trauma reviews and post-service).

Professional Experience
05/2012 to Current
Chief Medical Officer and Regional Medical Director Centene Corporation Cottage Hills, IL,

Manages physicians within Arizona

Project Development

Oversees and performs medical transactions

Problem-solves management issues

Works with other Regional Medical Directors in other states

Works with Contractors, Sales, Benefits and Compliance

Develops ROI projects with data analysis

Chairs local and national health plan committees

Works with medicaid, medicare, commercial and marketplace lines of business

Responsibility for provider RAF and Hedis participation

Worker with contractors to develop strategies for Inpatient and outpatient providers


04/2011 to 02/2012
Vice Chair of Psychiatry National Veterinary Associates Bloomington, IN,

Direct Patient Care

Supervision of new medical staff

Management of inpatient services

medical student education

10/2007 to 05/2011
Chief Medical Officer Arthur J Gallagher & Co. Franklin, TN,
  • Chaired the committee that proposed revisions of the BH Core Assessment and Instituted Medical Staff privileging related to the assessment.
  • Help to developed On-Line BH training for ED doctors
  • Chaired the development of TBI training for BH doctors/clinicians
  • Held the position as the Substance Authority for the State of Arizona
  • Initiated Health Initiatives for BH members on a quarterly schedule Participated in Peer Forums related to Medical Integration
  • Carried out Inspections of BH clinics
  • Worked with State Agencies on Mental Health Initiatives including the Attended Arizona Health Cost Containment Medical Directors Meetings
  • Provided Consultation to RBHA Forensic ACT teams
  • Managed Prevention, Quality Management, and BH Housing Instituted Peer Review Policies and Process at the State Level
  • Worked as the chief liaison between SAMHSA and DBHS
  • Coordinated communications between the Department of Behavioral Health and Gov. Office related to Substance Abuse.
11/2005 to 11/2007
CMO Accenture Madison, WI,

Managed Psychiatric doctors, internal medicine doctors, psychology staff, pharmacy staff

Chief Liaison between Friends Hospital and Drexel University Department of Psychiatry

Developed practice policies for Medical Staff and Quality Management Department

04/2003 to 11/2005
Forensic Coordinator Accenture New Orleans, LA,

Insanity and Competency evaluations

Patient management

Police and probation consultation

Court Testimony

Emergency room coverage

Teaching Residents and Students

11/2001 to 2003
Chair of Psychiatry Norristown City, STATE,
  • Direct Patient Care
  • Management of medical staff
  • C/L
  • Medical Executive Committee
04/1999 to 2001
Medical Director Northwest Community Hospital City, STATE,
  • Provided and help to develop treatment programs for adolescents *Provided community based education.
04/1999 to 2001
Senior Vice President Isaac Ray Center City, STATE,
  • Provided fitness for duty for U.S.Postal Inspectors
  • Management of the Forensic Fellowship program
  • Performed Sexual Behavior evaluations for the State of Illinois Provided consultation to the United States Secret Service
  • Provided corporate consultation to law firms, medical schools, business organization related to workplace violence
  • Provided clinical treatment within Cook County Jail
  • Served as a civil expert to Cavanaugh and Associates, Inc.
09/1994 to 03/1999
Assistant Professor of Psychiatry/Medical Director of Psychiatry and Law Program University Of Cincinnati City, STATE,

Teaching and Direct Patient Care

Emergency Room Attending

Residency Education

C/L

Public Psychiatrist for Ohio Department of Mental Health

03/1991 to 03/1994
Medical Director Foote Hospital City, STATE,
  • Group Practice
  • Medical Director of Adult Psychiatry and ECT services
  • Nursing home consultation
06/1989 to 06/1991
Medical Director Human Services Center Of S.D. City, STATE,

Direct Care- Adult and Adolescent

Correctional Direct Patient Care

Long-term Care Management

Education
Expected in 1985
M.D:
Meharry Medical College - Nashville, Tn.
GPA:
Expected in 1989
Psychiatry Certification of Residency Served as Chief Resident:
Univ. of New York - Buffalo, N.Y.
GPA:
Expected in 1986
Internal Medicine Certification of Internship:
Tulane University - New Orleans, La.
GPA:
Expected in 1981
B.S:
Louisiana Tech University - Ruston, La.
GPA:
Additional Information
  • Honors: National Public Health Service Award, District 7
  • Outstanding Teaching, Family Practice Program in South Dakota Golden Apple Award for Education
  • Honorary Fellow, Isaac Ray Center Service Award,
  • Arizona Department of Health African American Legislative Award Outstanding Physician Award 2009
Skills

Behavioral Health Risk Management , Communication skills, Consultation, Hiring, Leadership, Medical Cost Management, Peer Review, Policy Development, Pharmacy and Therapeutics Management, Process Improvement, Quality Management, Practice Risk Management, Medical Population Management

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Resume Overview

School Attended
  • Meharry Medical College
  • Univ. of New York
  • Tulane University
  • Louisiana Tech University
Job Titles Held:
  • Chief Medical Officer and Regional Medical Director
  • Vice Chair of Psychiatry
  • Chief Medical Officer
  • CMO
  • Forensic Coordinator
  • Chair of Psychiatry
  • Medical Director
  • Senior Vice President
  • Assistant Professor of Psychiatry/Medical Director of Psychiatry and Law Program
  • Medical Director
  • Medical Director
Degrees
  • M.D
  • Psychiatry Certification of Residency Served as Chief Resident
  • Internal Medicine Certification of Internship
  • B.S