Clinical Leadership Opportunity: Chief Clinical Officer of Utilization Management

7 days ago


Remote, Oregon, United States quantum-health Full time
Job Summary

We are seeking a highly experienced and skilled Chief Clinical Officer of Utilization Management to lead our clinical programs across the enterprise. The successful candidate will be responsible for driving clinical excellence, ensuring compliance with regulatory requirements, and developing strategic plans to improve member outcomes and reduce costs.

About Quantum Health

Quantum Health is a privately-owned healthcare navigation organization committed to making healthcare simpler and more effective for our members. With a team of over 2,000 professionals, we believe in building diverse and inclusive teams that share our passion for delivering exceptional care.

Responsibilities
  • Lead the development and implementation of clinical policies and guidelines to ensure high-quality care for our members.
  • Collaborate with Operations leadership to optimize clinical review quality, timing, and operational efficiency.
  • Oversee utilization management quality management, including the development of processes to monitor clinical outcomes and identify potential fraud, waste, and abuse.
  • Maintain strong relationships with clients' leadership regarding UM, clinical criteria, and policy issues.
Requirements
  • MD/DO with unrestricted license.
  • Board Certification by the American Board of Medical Specialties.
  • Minimum of 10 years in the health care industry, including 5 years' experience in clinical practice.
  • Minimum of 5 years' experience in a senior health care management position managing people and large-scale projects and initiatives.
What We Offer

At Quantum Health, we offer a competitive salary range of $200,000 - $250,000 per year, depending on experience, as well as a comprehensive benefits package, including health, vision, and dental insurance, 401(k) plan with up to 4% employer match, and paid time off. We also provide opportunities for professional growth and development through tuition reimbursement, certification/continuing education reimbursement, and paid trainings and leadership development.



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