Community Health Choice

Title: Chief Medical Officer - 77081

Location: Houston, TX

Specialties: Family Medicine, Internal Medicine, Pediatrics, Obstetrics and Gynecology

Summary

Provides clinical oversight for Care/Disease Management and Population Health programs. Participates in executive committees related to quality and compliance, leads clinical protocol development and quality improvement initiatives, supports utilization management and care coordination, and reports clinical activities to executive leadership and the board. Requires MD or DO, Texas licensure, board certification in primary care specialties, and extensive clinical and administrative experience.

Added on: 07/24/2025

Full Job Description

Chief Medical Officer

Work Schedule: Flexible.

Full time, Weekdays.

Duties

  • Provides clinical oversight of Care/Disease Management and Population Health programs:
  • Active participant in various Community Executive Committees including Quality, Compliance, and others as appropriate. Participates in Quality Improvement (QI) activities.
  • Collaborates with Leadership of the Quality function in the design and implementation of specific QI studies and initiatives.
  • Provides reports to Executive Leadership and the Board of Directors on Clinical Protocols and Quality Improvement activities.
  • Leads in development of Clinical protocols, risk-stratification, and policies based on evidence-based medicine and best practices.
  • Assists in development and review of patient materials and education activities related to CM/DM programs.
  • Provides clinical expertise for utilization management, care/disease management and care coordination programs. In collaboration with leadership of Care Management, the CMO:
  • Ensures that utilization decisions are based upon medical necessity, benefit plan, and utilization of approved care guidelines and protocols.
  • Coordinates in-house rounding to review and educate using real time cases.
  • Reviews, updates, and creates clinical policies as needed to ensure Care Management compliance with applicable standards and regulations.
  • Reviews and analyzes data and makes recommendations to the Care Management Leadership on ways to appropriately reduce medical expenses.
  • Responds to regulatory requests, complaints and appeals regarding UM issues as necessary.

Requirements

Education/Specialized Training/Licensure:

  • MD Degree or DO and Licensure in the State of Texas, Completion of Residency and Board Certification in Family Medicine, Internal Medicine, Pediatrics or OB/GYN with preference for the Primary Care Specialties

Work Experience (Years And Area)

  • Twelve years clinical experience with 5 years of administrative experience in Managed Care, including management of other physicians and/or clinical staff; master's degree in public health, Business Administration or Medical Administration preferred.

Management Experience (Years And Area)

  • 5 years of administrative experience in Health plan management, including management of other physicians and/or clinical staff.

Candidates must pass a drug screen and background check. (Due to the nature of employer's business, company policy requires that candidates having criminal background will not be considered for employment.)