Chief Medical Executive

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