State Licensed Chief Medical Officer

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