Chief Medical Officer (CMO)
About the Company
Innovative AI & machine learning software vendor
Industry
Computer Software
Type
Privately Held, VC-backed
Founded
2016
Employees
1001-5000
Funding
$6-$10 million
Specialties
About the Role
The Company is in search of a Chief Medical Officer (CMO) to serve as a physician executive and clinical leader, with a focus on driving trusted client relationships, guiding payment integrity policy, and representing the clinical voice in product innovation. The CMO will be responsible for building partnerships with client medical directors, payment integrity executives, and senior payer stakeholders, as well as shaping payer-specific payment policies and providing clinical and coding rationale during client interactions. This role requires a strong background in payment integrity, reimbursement operations, and claims auditing, with expertise across various claim types and a deep understanding of payer adjudication rules.
The ideal candidate for the CMO position at the company will have an MD or DO with an active license, at least 10 years of experience in the relevant fields, and a proven track record of executive-level client engagement. Key responsibilities include mentoring internal clinicians, guiding clinical playbooks, and shaping the product roadmap to ensure clinical content innovation. The CMO will also be expected to have a strong knowledge of industry standards and to collaborate closely with cross-functional teams to ensure that the company's outputs are clinically sound. Preferred qualifications include experience with pharmacy claims, PBM workflows, and advanced degrees such as an MBA, MPH, or MHA. The company is an equal-opportunity employer and is dedicated to fostering a diverse and inclusive workplace. Hiring Manager Title
CEO
Travel Percent
Less than 10%
Functions
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