Job Description

The Chief Medical Officer (CMO) for the Healthcare Services organization will be integral in the realization of the health plan's mission, by providing leadership and direction for health management and clinical quality improvement strategies, providing greater value to its members through pharmacy and medical management, and optimally functioning management systems.

This position based in San Francisco, will work with the Business Units to maximize the value and minimize the market risk of medical management by coordinating and aligning the strategies of benefit design, provider contracting, utilization review, medical policy and claims payment. The CMO is key member of the Senior Staff and provides input, strategic direction and serves as a clinical interface spokesperson in a wide variety of venues for the health plan.

Job Requirements

The ideal candidate will have 15 years of experience in a managed care setting; and proven experience with medical management, medical policy, quality, accreditation, pharmacy and program management.

Qualifications

Medical degree (MD or DO) from an accredited institution is required; completion of a Masters Degree program in Health Admin or Business Admin, or Certificate in Healthcare Management is preferred. Board certification is required as is an unrestricted California State Medical license.