Job Summary
A company is looking for a Chief Medical Officer.
Key Responsibilities
- Build trusted partnerships with client Medical Directors and senior payer stakeholders
- Shape payer-specific payment policies and provide clinical guidance during audits and appeals
- Collaborate with cross-functional teams to ensure clinically sound outputs and represent clinical perspectives in product innovation
Required Qualifications
- MD or DO with an active license
- 10+ years of experience in payment integrity, reimbursement operations, or claims auditing
- Strong knowledge of CMS, Medicare, Medicaid, and commercial payer adjudication rules
- Proven executive-level client engagement experience
- Demonstrated leadership with the ability to translate clinical insights into strategy
Comments