Chief Medical Officer Utilization Management Lead

2 weeks ago


Philadelphia, Pennsylvania, United States The Cigna Group Full time
Job Title: Chief Medical Officer Utilization Management

About the Role:

We are seeking a highly skilled and experienced Chief Medical Officer to lead our Utilization Management team. As a key member of our leadership team, you will be responsible for developing and implementing strategies to improve and maintain cost and utilization trends. You will work closely with our clinical and operational teams to ensure that our utilization management programs meet the highest standards of quality and compliance.

Key Responsibilities:

  • Develop and implement clinical policy and quality management programs to ensure optimal clinical outcomes and compliance with regulatory requirements.
  • Lead the development and implementation of utilization management programs to improve cost and utilization trends.
  • Collaborate with our clinical and operational teams to ensure seamless integration of clinical and business operations.
  • Develop and maintain strong relationships with key stakeholders, including clients, providers, and regulatory agencies.
  • Provide clinical leadership and expertise to support the development and implementation of new business initiatives.
  • Stay up-to-date with industry trends and developments, and apply this knowledge to inform our business strategies and operations.

Requirements:

  • MD or DO degree from an accredited institution.
  • 10+ years of experience in a leadership role, with a strong background in clinical operations and utilization management.
  • Proven track record of success in developing and implementing clinical policy and quality management programs.
  • Excellent communication and leadership skills, with the ability to work effectively with diverse stakeholders.
  • Strong analytical and problem-solving skills, with the ability to interpret complex data and develop effective solutions.

What We Offer:

We offer a competitive salary and benefits package, as well as opportunities for professional growth and development. If you are a motivated and experienced leader who is passionate about delivering high-quality clinical services, we encourage you to apply for this exciting opportunity.


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