Job Description

Overview

Chief Medical Officer (CMO) role at Rocky Mountain Health Care Services (RMHCS). The CMO provides strategic and operational medical leadership to ensure the highest standards of clinical quality, participant safety, and regulatory compliance. The CMO reports to the President and oversees medical policy, decision-making, and all medical affairs and clinical functions, including participant care, utilization management, quality assurance, and credentialing. The CMO fosters collaboration among providers, oversees clinical quality improvement initiatives, and represents the organization with regulators, community stakeholders, and the Board of Directors.

Mission: Improving lives, Optimizing wellness, Promoting independence

Responsibilities

• Provides overall leadership and oversight of RMHCS physicians and nurse practitioners, including hiring, supervision, evaluation, training, and education.
• Champions a culture that prioritizes provider well-being, resilience, and engagement, recognizing their essential role in delivering safe, high-quality participant care.
• Evaluates and improves medical service delivery, embraces best practices, and leads development of standards of care for RMHCS.
• Responsible for the delivery of participant care and clinical outcomes.
• Reviews pharmacy utilization, pharmacy reports, and processes.
• Leads the RMHCS utilization management program, including establishing evidence-based clinical criteria for diagnostic testing, referrals, procedures, hospital admissions, and post-acute care services.
• Leads review processes for high-cost/high-frequency or complex cases, monitors utilization trends, and identifies patterns of overuse or underuse.
• Works with interdisciplinary teams to align care delivery with clinical best practices, reduce unnecessary variation, and improve participant outcomes.
• Collaborates with RMHCS Executive Team to enhance organizational development, service delivery, and strategic initiatives.
• Ensures regulatory compliance, engages providers in peer-to-peer case discussions, and implements corrective action plans when utilization concerns are identified.
• Oversees the orientation/onboarding of new providers to PACE standards and regulations.
• Provides direct participant care as needed.

Credentialing & Quality Management

• Establish credentialing and re-credentialing standards for medical providers.
• Oversee RMHCS quality and performance improvement program in collaboration with CNO and COO. Direct and oversee clinical quality management, including identifying and measuring quality indicators, setting standards, and training staff to meet those standards.
• Maintain medical policies, procedures, standards, and protocols to adhere to state and federal regulations.
• Remain current with regulations and participate in committees as requested.

Network Development & Relationship Building

• Lead collaboration with the CEO to engage health care providers, community leaders, and state/federal entities to advance the RMHCS PACE program.
• Advocate for RMHCS and strengthen provider community involvement.
• Collaborate with colleagues and providers in the community; represent RMHCS in national and local forums.
• Build and maintain strong relationships with the Executive Leadership Team.
• Other duties as assigned.
• MD or DO required; licensed to practice medicine in Colorado; DEA registration and ability to obtain/maintain staff privileges at RMHCS contracted hospitals required.
• ABMS Board Certified in Internal Medicine or Family Practice; advanced certification in geriatrics preferred.
• One year of primary care experience with a frail elderly population required.
• One year of Chief Medical Officer experience preferred.
• Current BLS Certification required.
• Knowledge of the physical, mental and social needs of frail older adults; skills in physical assessment and chronic disease management for frail older adults.
• Excellent written and verbal communication skills; ability to interact clearly with internal and external customers.
• Ability to work effectively in an interdisciplinary team; manage changing priorities per participant needs; strong organizational skills; willingness to learn and work with diverse cultural factors affecting health care of adults and the elderly.
• Demonstrates necessary skills and knowledge as outlined in position-specific Competency Assessment Profile.

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