CMO Chief Medical Officer – Sacramento, California

  • Location: Sacramento, California
  • Type: Permanent
  • Job #34274
  • 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 and has over 450,000 residents 
  • It has plentiful amenities including an int'l airport and an NBA basketball team
  • San Francisco is only 1.5 hours, Napa is 30 minutes and Lake Tahoe is 2 hours
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