Physician / Internal Medicine / California / Permanent / CMO Chief Medical Offic
Integrity Healthcare..., Sacramento, CA, United States
Salary max: $156.00
Duration: Full Time
- Chief Medical Officer (CMO) position in a senior executive leadership role
- Full-time, day shift; salary range $325,000"$350,000 per year
- Key member of the senior executive team responsible for overall clinical vision and business strategy
- Provides medical oversight, expertise, and leadership across all divisions to ensure high-quality care
- Leads development and implementation of innovative clinical programs with plan sponsors and regulatory partners
- Spends at least 50% of time managing the authorization queue, similar to other Medical Directors
- Manages authorizations in a timely manner, meeting or exceeding turnaround requirements
- Oversees activities related to cost management, utilization review, quality assurance, and medical protocol development
- Supervises and participates in recruiting and credentialing physicians
- Partners with Utilization Management to improve medical management programs and integrate other clinical programs
- Reports to the CEO and/or governing body
- Attends board and committee meetings and monitors quality and appropriateness of care
- Provides guidance on performance guidelines and assists with policy and procedure development
- Participates in strategic planning, clinical peer review oversight, documentation, and care planning
- Assists in managing physician relations and representing physician interests
- Participates in adjudicating first-level provider appeals and addressing emergency issues
- Supports provider education and community relations
- Performs transactional activities including prior auth, concurrent review, retro review, and claim review
- Provides oversight of medical care management and utilization review across all offices
- Offers clinical guidance for complex medical decision-making and care coordination
- Ensures contractual and legislative compliance standards are met
- Assists in training physicians, pharmacists, case managers, and UM staff
- Develops proficiency with internal software and carve out programs (e.g., CCS, LEA)
- Coordinates with contracted health plans, county health agencies, and medical providers to implement programs and resolve case management issues
- Acts as a medical resource to staff and maintains professional affiliations to stay current in medical trends
- Upholds company policies, confidentiality standards, and contributes to a positive, safe work environment
- Supervises multiple Medical Directors
- At least 5 years of clinical practice experience required
- At least 2 years of managed care/health plan or medical group utilization management and quality improvement experience (e.g., NCQA, CMS, guideline development)
- At least 2 years experience with Medi-Cal/Medicare required
- Strong oral and written communication skills and ability to interpret complex guidelines
- Excellent active listening, critical thinking, and customer service skills
- Proven ability to solve advanced problems with minimal supervision and to work collaboratively
- Strong time management, organization, and multi-tasking abilities in a fast-paced environment
- Comfortable giving and receiving constructive feedback
- Professional presence with ability to represent the organization effectively
- Sacramento is the state's capital andhas over 450,000 residents
- It has plentiful amenities including anint'l airport and an NBA basketball team
- San Francisco is only 1.5 hours, Napa is 30 minutes and Lake Tahoe is 2 hours