Chief Medical Officer, Clinical Assessment Review Expert

Chief Medical Officer, Clinical Assessment Review Expert

About the Company

Successful healthcare services provider

Industry

Hospital & Health Care

Type

Public Company

Founded

1977

Employees

10,001+

Categories

• Health Care
• Medical
• Wellness
• About Us
• General Page
• Holding Companies
• Life and Health Insurance
• Funds
• Employee Management
• Insurance
• HMO
• Medical Centers
• Outpatient

Specialties

Business Classifications

About the Role

The Company is seeking a Chief Medical Officer for its Clinical Assessment Review Expert (CAREs) team. This executive leadership role is pivotal in ensuring the national clinical programs meet key objectives across clinical quality, growth, and financial performance. The successful candidate will be a visionary and innovative leader with a strong background in clinical and operational management, particularly in the area of Utilization Management. Responsibilities include managing a team that monitors clinical, affordability, and operational outcomes, providing strategic leadership in collaboration with various partners, and supporting the organization in identifying emerging clinical trends. The role also involves evaluating clinical data to identify improvement opportunities, developing key messages for external stakeholders, and proactively identifying growth opportunities.

Applicants must have a Doctor of Medicine (MD or DO) degree with an unrestricted medical license, at least 10 years of clinical practice experience, and a minimum of 5 years of progressive national leadership experience in managing Utilization Management teams. A solid business foundation, expertise in Utilization Management principles, and a proven track record of success in healthcare delivery systems are essential. The role requires proficiency in evidence-based clinical decision-making tools, a strong operational orientation, and the ability to collaborate within highly matrixed environments. The ideal candidate will be a strategic thinker with robust business acumen, capable of aligning clinical strategies with business goals, and have a strong belief in evidence-based medicine.

Hiring Manager Title

National Chief Medical Officer of Medical Management

Travel Percent

Less than 10%

Functions