DescriptionLocation: This position may work remotely anywhere in the United States of America.We're on a mission to make healthcare simpler and more effective. We fight to ensure our members get the care they need, when they need it, at the most affordable cost - that's why we call ourselves Healthcare Warriors. We're committed to building diverse and inclusive teams, so if you're excited about this position, we encourage you to apply - even if your experience doesn't match every requirement.The Chief Medical Officer (CMO) serves as a member of our executive team, providing overall clinical leadership in delivering safe, affordable, equitable care and high-quality member experience. The CMO focuses on developing and expanding our philosophy of care, engaging our clinical teams in shared core values, advancing our clinical service and product offerings, and leading clinical quality.The CMO will actively work to enhance our clinical scale, grow our core healthcare navigation offering and guide our expansion into new markets. They will combine market insights/trends, clinical strategy and program development, and execution and outcomes delivery responsibilities. They will oversee and influence the development and delivery of our clinical identification and stratification model, high-cost case and physician engagement, clinical program management and client offerings.What you'll doProvide strategic leadership for the innovation and monetization of clinical products and services that improve the health outcomes of our members and maximizes return on investment for our clients.Develop solid collaborative partnerships across a highly complex and matrixed organization including key partnerships with the leadership team, functional VPs, across all functional teams.Participate in executive strategy development and implementation to ensure that appropriate care and services provided to members meet best practice standards as well as regulatory compliance requirements and Internal Quality Assurance Program.Oversee clinical processes and policy decisions with a focus on implementing plans of care that meet accepted guidelines and protocols to ensure that optimal and appropriate medical and clinical services are provided.Ensure clinical services are delivered to members at the highest quality standards.Serve as clinical subject matter expert for needs assessment, design, implementation, and evaluation of clinical programs to support continued growth and affordability.Lead in the development of clinical programs, including new care management programs to drive down trend and cost of care, potentially including partnering with the care delivery system (internal and external) on UM/CM best practices and shared operations.Provide strategic leadership for core Medical Management and Rx Operations, UM/CM, member engagement, policy development / alignment / synchronization.Interact with and effectively represent Quantum Health with prospective and current clients, clinical advisory boards and board of directors.Ensure compliance with clinical goals through monitoring care management performance.Responsible for recommending changes and enhancements to current managed care, review guidelines, and clinical criteria based on extensive knowledge of health care delivery systems, utilization methods, reimbursement methods, and treatment protocols.Develops, implements, and interprets medical policy including medical necessity criteria, clinical practice guidelines, new technology assessments and cost management.Works directly with business unit leads to promote excellence in care and service delivery.Be a visionary for our clinically oriented navigation model.Evangelize our care model with internal and external stakeholders.Collaborate with internal experts in improving processes, systems and policies that improve patient care.Help shape lo