State Licensed Chief Medical Officer

Job Summary

Providing administrative oversight to the medical staff, the full-time remote State Licensed Chief Medical Officer will analyze medical review utilization data, develop and revise medical policies, and act as a lead resource for providers and internal staff on medical policy issues.

Key responsibilities

• Support operations through case review on medical and regulatory matters and develop claim adjudication criteria
• Educate staff and the medical community on medical policy and program administration
• Conduct research into new or controversial medical procedures and technology while developing external relationships with the medical community

Required qualifications

• Doctorate in a job-related field
• Active state medical license and current board certification in a recognized specialty
• 5 years of post-graduate experience in direct patient care
• Proficiency in Microsoft Office
• Experience with Medicare Part A is preferred