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Confidential

Executive Chief Medical Officer

Confidential, Phila, Pennsylvania, United States, 19117

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Executive Chief Medical Officer About the Company Join a pioneering AI & machine learning software provider that is transforming the healthcare landscape. 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 Administration Healthcare Claims AI Coordination of Benefits Healthcare IT Healthcare Payment Process About the Role We are seeking an accomplished Executive Chief Medical Officer (CMO) to take on a pivotal role in enhancing client relations, shaping payment integrity policies, and providing the clinical insight necessary for innovative product development. In this key position, you will forge strong partnerships with client medical directors and senior payer stakeholders, all while influencing payer-specific policies and ensuring clinical accuracy in coding discussions. The successful candidate will possess an MD or DO with a current license, backed by a minimum of 10 years of relevant experience and a proven track record in executive-level client engagement. Your key responsibilities will include mentoring our internal clinical team, refining clinical playbooks, and helping to shape a product roadmap that prioritizes clinical innovation. Your deep expertise in payment integrity, reimbursement operations, and claims auditing—particularly across various claim types and payer adjudication rules—is essential. Additionally, experience with pharmacy claims and PBM workflows, along with advanced qualifications like an MBA, MPH, or MHA, are highly desirable. At our organization, we pride ourselves on being an equal-opportunity employer committed to cultivating a diverse and inclusive work environment. We look forward to welcoming visionary leaders who share our mission. Hiring Manager Title CEO Travel Percent Less than 10% Functions Medical Care/Hospital Administration