Chief Medical Officer

POSITION SUMMARY: The Chief Medical Officer (CMO) provides strategic and operational medical leadership to Rocky Mountain Health Care Services, ensuring the highest standards of clinical quality, participant safety, and regulatory compliance. Reporting directly to the President, the CMO is responsible for medical policy, decision-making, and oversight of 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

COMPETENCIES:

• Sound Clinical Judgment
• Effective Communication & Collaboration
• Effective Supervision and Coaching
• Quality Focus
• Strategic Focus
• Conflict Management
• Facilitates Change
• Professionalism
• Decisiveness & Problem-Solving

RESPONSIBILITIES AND DUTIES:

ESSENTIAL JOB FUNCTIONS: 

Medical Leadership

• Provides overall leadership and oversight of RMHCS physicians and nurse practitioners, including their 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 embracing implementation of best practices for RMHCS and leads development of standards of care for RMHCS.
• Responsible for the delivery of participant care and clinical outcomes.
• Review of pharmacy utilization, pharmacy reports and processes. 
• Leadership/collaboration of the RMHCS utilization management program, encompassing both pharmacy and comprehensive medical services. This includes establishing and maintaining evidence-based clinical criteria for appropriate use of diagnostic testing, specialty referrals, procedures, hospital admissions, and post-acute care services.
• The CMO will lead review processes for high-cost, high-frequency, or complex cases, monitor utilization trends, and identify patterns of overuse or underuse.
• The CMO will work closely with interdisciplinary teams to align care delivery with clinical best practices, reduce unnecessary variation, and improve participant outcomes.
• Collaborate with RMHCS Executive Team to enhance organizational development, service delivery, and strategic initiatives.
• Ensures compliance with regulatory requirements, engaging providers in peer-to-peer case discussions, and implementing corrective action plans when utilization concerns are identified.
• Oversee 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.
• Implementation and oversight of the RMHCS quality and performance improvement program in collaboration with Chief Nursing Officer (CNO) and Chief Operations Officer (COO). Direct and oversee clinical quality management, including identification and measurement of quality indicators, determination of appropriate standards and the training of staff to meet those standards.
• Maintenance of medical policies and procedures, standards, and protocols to adhere to state and federal regulations.
• Adheres to and remains current with regulations.
• Leads or participates in various committees as requested.

Network Development & Relationship Building

• Serve in a leadership role, in collaboration with the Chief Executive Officer, with the health care provider community, key community leaders as well as State and Federal entities to advance the RMHCS PACE program.
• Serve as an advocate for RMHCS and enhances the involvement of the provider community.
• Actively participates and collaborates among colleagues and providers in the community.
• Play a visible role in representing RMHCS in national and local forums.
• Build and maintain strong, professional relationships with other members of the Executive Leadership Team.
• Other duties as assigned.

QUALIFICATIONS AND REQUIREMENTS:

• MD or DO Degree required.
• Must be licensed to practice medicine in the State of Colorado.
• DEA registration and ability to obtain and 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 is required.
• One year of Chief Medical Officer experience is preferred.
• Current BLS Certification is required.
• Knowledge of the physical, mental and social needs of frail older adults.
• Effective skills in physical assessment and chronic disease management for frail older adults.
• Must have excellent written and verbal communication skills and demonstrate the ability to interact clearly and effectively with both internal and external customers.
• Ability to work effectively in an interdisciplinary team environment.
• Ability to manage changing priorities per participant needs.
• Strong organizational skills.
• Understanding of and willingness to learn and to work with diverse cultural factors that affect health and health care of adults and the elderly.
• Demonstrates necessary skills and knowledge as outlined in position-specific Competency Assessment Profile.