Confidential
Chief Medical Executive
About the Company
Join an innovative AI and machine learning software vendor at the forefront of transforming healthcare.
Industry
Computer Software
Type
Privately Held, VC-backed
Founded
2016
Employees
1001-5000
Funding
$6-$10 million
Specialties
machine learning
deep learning
large-scale data processing
cluster computing
real-time predictions
nlp
data to cash
payment integrity
subrogation
data mining
cost containment
healthcare admin
healthcare claims
ai
coordination of benefits
healthcare it
healthcare payment process
About the Role
We are seeking a Chief Medical Executive (CME) to become a pivotal physician leader within our company. In this role, you will enhance client relationships, influence payment integrity policy, and ensure the clinical voice drives our product innovation.
You will be responsible for nurturing collaborations with client medical directors, payment integrity executives, and senior payer stakeholders. Your expertise will shape payer-specific payment policies and provide essential clinical and coding insights during client engagements. This position requires substantial knowledge in payment integrity, reimbursement operations, and claims auditing, with a strong grasp of various claim types and payer adjudication rules.
The ideal candidate will possess an MD or DO with an active license, at least 10 years of relevant experience, and a demonstrated record of executive-level client engagement. Key responsibilities include mentoring internal clinicians, creating clinical playbooks, and influencing the product roadmap to drive clinical innovation. You will also be expected to bring strong expertise in industry standards and collaborate closely with cross-functional teams to ensure that our outputs are clinically robust.
Preferred qualifications include experience with pharmacy claims, PBM workflows, and advanced degrees such as an MBA, MPH, or MHA. We are proud to be an equal-opportunity employer, dedicated to nurturing a diverse and inclusive workplace.
Hiring Manager Title
CEO
Travel Percent
Less than 10%
Functions
Medical Care/Hospital Administration