Job Posting Title

EGID Chief Medical Officer

Agency

807 HEALTH CARE AUTHORITY

Supervisory Organization

EGID

Job Posting End Date (Continuous if Blank)

July 15, 2025

Note: Applications will be accepted until 11:59 PM on the day prior to the posting end date above.

Estimated Appointment End Date (Continuous if Blank)

Full/Part-Time

Full time

Job Type

Regular

Compensation

Salary based on education and experience.

Job Description

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