Chief Medical Officer, Health Value

Altais

California, US
Base: $342,000 - $385,560pyear; bonus/equity: elig...
Managed care environment experience
Utilization management policy development
Health plan appeals and hmo hearings
The Chief Medical Officer serves as the primary medical leader interfacing with health plans to resolve escalated benefits, coverage, and administrative issues

Job Summary

  • The Chief Medical Officer serves as the primary medical leader interfacing with health plans to resolve escalated benefits, coverage, and administrative issues.
  • This role is accountable for Medical Loss Ratio results and leads claims analysis to drive cost-effective care strategies without compromising patient outcomes.
  • Candidates must possess at least ten years of practice in a managed care environment and four years of management experience within a physician group model.

Matching Summary

The Chief Medical Officer serves as the primary medical leader interfacing with health plans to resolve escalated benefits, coverage, and administrative issues.

Salary

Base: $342,000 - $385,560/year; Bonus/Equity: Eligible for annual bonus program; Benefits: Excellent medical, vision, dental, 401k match, flexible time off

Skills & Requirements

Must-have

  • Managed Care environment experience
  • Utilization Management policy development
  • Health plan appeals and HMO hearings
  • Credentialing committee chairmanship
  • Medical Loss Ratio accountability
  • Risk adjustment and coding oversight

Nice-to-have

  • Thought leader provider relationships
  • Collaborative team-based care model
  • Pharmacy strategic leadership
  • Patient experience enhancement initiatives
  • Fast-paced dynamic team adaptation

Key Requirements

  • Doctor of Medicine degree required
  • Current Board certification preferred
  • Active California MD licensure
  • Minimum 10 years managed care experience
  • 4 years management experience required
  • Health plan operations experience

Work Rights

Not specified

Tailored Resume

Cover Letter