Chief Medical Officer / Medical Director

Group 1001 is a consumer-centric, technology-driven family of insurance companies on a mission to deliver outstanding value and operational performance by combining financial strength and stability with deep insurance expertise and a can-do culture.

Clear Spring Health is part of Group One Thousand One (Group1001), a customer-centric insurance group whose mission is to make insurance more useful, intuitive, and accessible so that everyone feels empowered to achieve financial security. Clear Spring Health is dedicated to helping seniors protect their health and well-being by providing Medicare Advantage plans in select counties of Colorado, Illinois, North Carolina, and Virginia, plus Georgia and South Carolina and offers Medicare Prescription Drug Plans in 42 states plus DC.

At Clear Spring Health, we believe in simplifying health to enrich lives. As our Medical Director, youll help lead the way in delivering high-quality, person-centered care to the people we serve. This role is central to ensuring our Medicare Advantage members receive care thats thoughtful, timely, and based on what works best.

Responsibilities :

• Assists clinical teams to ensure prompt and reliable communication with members and providers.
• Offers strategic input on the operational components of clinical programs.
• Conducts collaborative peer-to-peer clinical evaluations with attending physicians or other healthcare professionals to discuss case outcomes and patient consultations.
• Participate in peer-to-peer appeal review discussions with attending physicians or ordering providers to clarify review results.
• Acts as a trusted advisor and subject matter expert for various departments across the organization.
• May be asked to represent the organization in external engagements and / or serve on both internal and external panels or committees.
• May preside over internal corporate committees.
• Interprets clinical protocols and healthcare policies.
• May recommend and design new clinical policies in response to evolving medical practices and trends.
• Oversees, shapes, and drives both clinical and administrative initiatives that influence healthcare outcomes, cost-effectiveness, and quality.
• Recognizes and advances innovative solutions to improve efficiency and enhance service excellence.

Requirements :

Nice to Have :

Group 1001, and its affiliated companies, is strongly committed to providing a supportive work environment where employee differences are valued. Diversity is an essential ingredient in making Group 1001 a welcoming place to work and is fundamental in building a high-performance team. Diversity embodies all the differences that make us unique individuals. All employees share the responsibility for maintaining a workplace culture of dignity, respect, understanding, and appreciation of individual and group differences.

Our compensation reflects the cost of labor across several U.S. geographic markets. The base pay for this position ranges from $200,000 / year in our lowest geographic market up to $250,000 / year in our highest geographic market. Pay is based on factors such as market location, job-related skills, and experience.

Employees who meet benefit eligibility guidelines and work 30 hours or more weekly, have the ability to enroll in Group 1001s benefits package. Employees (and their families) are eligible to participate in the Companys comprehensive health, dental, and vision insurance plan options. Employees are also eligible for Basic and Supplemental Life Insurance, Short and Long-Term Disability. All employees (regardless of hours worked) have immediate access to the Companys Employee Assistance Program and wellness programsno enrollment is required. Employees may also participate in the Companys 401K plan, with matching contributions by the Company.

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