Job Description

Join to apply for the EGID Chief Medical Officer role at State of Oklahoma 2 days ago Be among the first 25 applicants Join to apply for the EGID Chief Medical Officer role at State of Oklahoma Get AI-powered advice on this job and more exclusive features. Agency/Division Information The Oklahoma Health Care Authority (OHCA) works to ensure Oklahomans have access to better health and better care. The agency’s core values include passion for purpose, trust and transparency, empowerment and accountability, best in class and outcome-driven, and servant leadership. As part of the interview process, candidates may be required to attend an in-person interview at our Oklahoma City office. Agency/Division Information The Oklahoma Health Care Authority (OHCA) works to ensure Oklahomans have access to better health and better care. The agency’s core values include passion for purpose, trust and transparency, empowerment and accountability, best in class and outcome-driven, and servant leadership. As part of the interview process, candidates may be required to attend an in-person interview at our Oklahoma City office. Position Purpose The Chief Medical Officer (CMO) serves as the senior clinical leader responsible for the oversight, direction, and continuous improvement of medical services within the HealthChoice / Employees Group Insurance Division (EGID). This role requires a licensed Medical Doctor (MD) or Doctor of Osteopathy (DO) with a deep understanding of healthcare systems, medical policy, and regulatory compliance. As a licensed MD or DO, the Chief Medical Officer ensures that all covered medical services meet high standards of care and align with organizational goals. The position leads strategic initiatives, provides medical expertise for operational decisions, and collaborates across departments to drive quality and cost-effective care. The CMO’s leadership is pivotal in aligning medical practices with statutory requirements and optimizing healthcare outcomes for HealthChoice members. Principle Activities May Include Medical Oversight and Clinical Guidance: Provide expert medical review and clinical leadership for utilization management, case management, appeals, and policy development. As a licensed MD or DO, the CMO ensures medical determinations meet accepted standards of care and evidence-based guidelines. Strategic Planning and Operational Leadership: Lead the development and execution of divisional goals, adjust operational strategies to enhance program performance, and supervise professional staff. Evaluate division operations systematically and implement improvements for efficiency and effectiveness. Policy Interpretation and Regulatory Alignment: Interpret federal and state legislation affecting medical policy. Advise internal stakeholders and collaborate with OMES/EGID and Actuaries to assess the impact of statutory changes on group insurance medical benefits. Quality and Performance Management: Administer performance standards with measurable criteria to ensure compliance with laws, policies, and clinical best practices. Establish and uphold benchmarks to drive excellence in service delivery. Team Development and Knowledge Transfer: Cultivate a high-performing team by identifying training needs, ensuring staff development, and fostering a culture of continuous learning. Mentor medical and administrative staff to elevate performance and maintain up-to-date medical knowledge. Medical Determinations and Appeals: Participate in determinations of coverage and clinical appropriateness for medical and pharmacy appeals, exceptions to network care, and novel treatment requests. A current Oklahoma MD or DO license is required to fulfill these responsibilities. Other duties as assigned. Supervisory Responsibilities: This position supervises. Qualifications : To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Knowledge, Skills, Abilities And Competencies The EGID Chief Medical Officer position requires a deep understanding of medical standards and clinical practices, coupled with strong leadership and the ability to analyze healthcare utilization data effectively. The role demands extensive medical knowledge to provide expert oversight of healthcare services, ensuring compliance with medical policies and standards, and determining coverage and certification requirements of new CPT/HCPCs codes. Additionally, proficiency in healthcare data analysis is crucial for identifying trends, cost shifts, and quality concerns, as well as generating actionable insights to improve healthcare delivery. Strong leadership and strategic planning skills are also essential, enabling the Medical Director to guide division operations, foster team collaboration, and align initiatives with broader organizational goals. Key Korn Ferry competencies such as Strategic Mindset and Drives Vision and Purpose are especially relevant, as the role requires visionary leadership and a focus on driving long-term organizational success. **To be considered for this position your application must include a resume/CV with complete work and education history.** Education And/or Experience A bachelor’s degree in public health or health related degree, business administration or a closely related field. Current license to practice medicine as a Medical Doctor (MD) or Doctor of Osteopathy (DO) in the state of Oklahoma AND 5 years of clinical practice experience as a licensed physician in Oklahoma (or ability to obtain Oklahoma licensure). Preference May Be Given To Candidates With MD or DO License with at least 10 years’ experience Working knowledge of CPT/HCPCS coding Supervisory and leadership experience Excellent public/physician relations Ability to work well with others on executive staff Physical Demands Must be able to remain sitting for prolonged periods at a desk and working on a computer. Must be able to move or lift up to 15 pounds at various times. Work Environment The office work environment includes regular exposure to general office equipment such as computer equipment, phones, and copy machines. Why You’ll Love Working Here At The Oklahoma Health Care Authority (OHCA), We’re Proud To Create a Workplace Where Employees Thrive. Named a Top Workplace In Oklahoma For Five Consecutive Years, This Achievement Reflects The Dedication And Collaborative Spirit Of Our Incredible Team. Here's What We Offer To Support Employees And Their Family Generous state-paid benefit allowance to offset insurance premiums. A wide selection of top-tier health insurance plans. Optional flexible spending accounts for health care or dependent care expenses. Employee Assistance Program (EAP) offering confidential support. Wellness benefits, including an on-site gym and fitness center discounts. 11 paid holidays annually. 15 vacation days and 15 sick days in your first year. Retirement Savings Plan with substantial employer contributions. Longevity Bonus to reward years of service. Public Service Loan Forgiveness eligibility and reimbursement for educational expenses. Professional development training opportunities, including CEU support. Accommodation Statement The Oklahoma Health Care Authority complies with applicable State and Federal civil rights laws and does not discriminate. All qualified applicants will receive consideration for employment without regard to race, color, sex, religion, disability, age, national origin, or genetic information. If a reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact the Civil Rights Coordinator at 405-522-7335. Notice To Applicants Please add OHCAHR@okhca.org to the address book or “safe-senders” list in your email. All correspondence will come from this address. Be sure to check your junk folder. If you have questions about the status of your application, you can contact the HR team at 405-522-7093. Note: Applications will be accepted until 11:59 PM on the day prior to the posting end date above. Current State of Oklahoma employees must apply for open positions internally through Workday Jobs Hub . Seniority level Seniority level Executive Employment type Employment type Full-time Job function Job function Health Care Provider Industries Government Administration Referrals increase your chances of interviewing at State of Oklahoma by 2x Sign in to set job alerts for “Chief Medical Officer” roles. 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