DUTIES AND RESPONSIBILITIES

Leads, directs and/or gives implementation support to programs that improve the health or quality of care for the populations served.

Leads, orchestrates, implements, and/or sponsors programs to evaluate the quality of care. This evaluation enables the leveraging of new or existing purchasing and payment strategies.

Supports the negotiation and monitoring of health-related contracts. Negotiations can include deliberations on scopes of work, payment rates and structures, and terms and conditions.

Leads efforts in better addressing the social determinants of health.

Develops, leads, and/or participates in quality oversight for significant aspects of leveraging Medicaid for both county provided and contracted services.

Provides medical leadership and consultation for employee benefit design, for correctional health and behavioral health at both the Metropolitan Detention Center (MDC) and the Adolescent Services Center, for the Medical Directors of Fire/EMS, and for the 911 Emergency Contact Center (ECC).

In accordance with Ordinance No. 2024-15, provides Medical Director services to the Behavioral Health Authority Division.

Provides guidance to ensure greater integration of health and behavioral health care for those with Intellectual and Developmental Disabilities (IDD) and those with Traumatic Brain Injuries (TBI).

Provides direct medical consultation for policy development, case reviews, and appeals.

Serves as liaison with health and behavioral health care providers, the NM Medicaid Medical Director, Medicaid managed care medical directors, University of New Mexico Hospital Medical Directors, and other clinical partners to achieve program goals.

Provides leadership to ensure that BernCo maintains its various national health and behavioral health accreditations.

Identifies operational problems and formulates appropriate solutions.

Prepares executive-level reports and correspondence.

Acts as liaison and exchanges information with a variety of outside organizations.

Communicates effectively orally and in writing.

Establishes effective working relationships with management, employees, employee representatives and the public representing diverse cultures and backgrounds.

Communicates effectively with a variety of individuals representing diverse cultures and backgrounds and function calmly in situations which require a high degree of sensitivity, tact and diplomacy.

Works with the NM Health Care Workforce Committee overseen by the UNM Health Sciences Center, and other allies, to seek solutions to better address health and behavioral health workforce shortages statewide.

*The above information is intended to outline the general nature and scope of the duties required for this position. It is not an exhaustive list and may vary depending on specific job assignments and responsibilities.

MINIMUM QUALIFICATIONS

Licensed to practice medicine in the state of NM or ability to obtain within 90 days of hire, under the medical licensure compact.

Two (2) years of related work experience.

*Any equivalent combination of related education and/or experience may be considered for the above requirements.

SUPPLEMENTAL INFORMATION

PREFERENCES

MD or DO, Board certified in adult, pediatrics, family medicine, or internal medicine preferred, and other specialties with appropriate experience.

Board certified in adult and/or child psychiatry; and/or Certified Addictionologist.

Advance degree: MPH, MBA, MPA, or related degree.

Minimum of seven (7) years of clinical experience as a practicing physician with three years of serving Medicaid clients preferred.

At least three (3) to five (5) years of direct administrative experience with a Medicaid program or managed care organization, or experience that demonstrates the ability to perform the essential functions of this position preferred.

KNOWLEDGE, SKILLS AND ABILITIES / COMPETENCIES

Working knowledge of:

Delivery system redesign.

Quality improvement principles.

Utilization management principles.

Evidence-based, patient-centered care principles.

Principles and techniques used in negotiation as applied to health service contracts and equipment purchasing.

Behavioral health care.

General and preventive medicine, and the relationship of behavioral and physical illness to those areas of medicine.

Principles and practices of supervision, personnel, employee relations, training, and general administration

Disease management and care coordination principles.

Insurance industry and managed care principles.

Demonstrated ability to be data driven, with a working knowledge of electronic health records (EHR), management information systems, statistical analysis, and outcome data analysis.

Proven skills developing and implementing practice guidelines.

Implementation experience in change management.

Understanding of and commitment to public/population health principles.

Solid written and oral communication skills, including the ability to articulate issues in a concise manner, understandable to a wide range of audiences.

Extensive understanding of the health and behavioral health care delivery system within a broader national marketplace.

Understanding of the basic authority (state and federal law and rules) governing Medicaid and Medicaid provider contracting, credentialing, and payment.

Understanding of how to participate in the policy-making process as a lead professional county representative

Effective interpersonal influence, collaboration and listening skills.

Proven ability to listen, collaborate, problem-solve, and negotiate with colleagues and adversaries.

Solid management skills necessary to inspire, seek consensus, build teams, and manage conflict.

Strong leadership skills necessary to analyze and articulate complex policy concepts, envision change, and promote creative and innovative approaches.

Must be able to obtain a medical license in New Mexico (If not already currently licensed to practice medicine in the State of NM).

SCREENING AND COMPLIANCE

The offer of this Bernalillo County position requires compliance with the following:

• Successful completion of a post-offer employment medical examination and background investigation.
• Adherence to all County safety guidelines.
• Complete all FEMA training(s) assigned to this position.
• Possession of a valid New Mexico driver’s license by the date of hire and maintenance of a valid license while employed in this position.
• Complete required supervisor training, if applicable.

WORKING CONDITIONS

• Duties are performed indoors in a temperature-controlled environment.
• Duties are performed on an even, typically dry surface, such as concrete, tile, or carpet.
• Work is conducted with a select team without direct supervision and may at times involve working with a large group.
• May be required to work extended hours.

EQUIPMENT, TOOLS, AND MATERIALS

• Equipment typically used includes a telephone, computer, printer, and copy machine.
• May occasionally drive a county vehicle.