Chief Medical Officer

At the Oklahoma Health Care Authority (OHCA), your work matters. Every day, our team helps ensure Oklahomans have access to better health and better care. Guided by our core values,
** Passion for Purpose, Trust & Transparency, Empowerment & Accountability, Best-in-Class, Outcome-Driven, and Servant Leadership**, we foster a workplace where people feel supported, respected, and empowered to make an impact.
* Generous state-paid  to offset insurance premiums.
* A wide selection of  with no pre-existing condition exclusions.
* for health care and dependent care.
* with employer contributions.
* 11 paid holidays annually.
* 15 days of vacation and 15 days of sick leave in the first year.
* Longevity Bonus recognizing years of public service.
* Public Service Loan Forgiveness eligibility and tuition reimbursement.
* Wellness benefits, including an on-site gym and fitness center discounts.
* ** Strategic Planning and Operational Leadership**:
Lead the development and execution of divisional goals; adjust operational strategies to enhance program performance; supervise professional staff; and systematically evaluate division operations to implement improvements in efficiency, effectiveness, and fiscal accountability.
* ** Medical Management and Systems Oversight**:
Oversee medical management activities, including utilization review, determinations of medical necessity, coverage decisions, exceptions to network care, and review of novel or emerging treatment requests. Provide clinical direction and oversight for Medicaid Management Information System (MMIS), claims editing, and fraud, waste, and abuse detection systems to ensure consistent application of medical policy.
* ** Quality and Performance Management**:
Administer performance standards with measurable criteria to ensure compliance with laws, policies, and clinical best practices. Oversee quality assurance, performance improvement initiatives, External Quality Review Organization (EQRO) activities, and quality oversight committees. Establish benchmarks to promote continuous improvement and excellence in service delivery.
* Other duties as assigned.
** Medical Oversight and Clinical Guidance**:
Provide expert medical review and executive-level clinical leadership for utilization management, case management, medical necessity determinations, appeals, quality improvement, program integrity, and policy development activities. Ensure all medical determinations meet accepted standards of care, evidence-based guidelines, and applicable federal and state requirements.
** Policy Interpretation, Development, and Regulatory Alignment**:
Interpret federal and state legislation and regulations affecting medical, behavioral health, dental, and pharmacy policy. Provide regular clinical and strategic input on the potential impact of policy and operational decisions on health care delivery. Advise internal leadership and collaborate with OMES/EGID, actuaries, and other partners to assess statutory and regulatory impacts on benefits and programs.
** Leadership, Supervision, and Knowledge Transfer**:
Lead, mentor, and supervise Medical and Dental Directors, consultants, and clinical and administrative staff. Identify training needs, support professional development, and foster a culture of continuous learning and accountability to maintain current medical knowledge and elevate team performance.
** Stakeholder Engagement and Representation**:
Partner with internal and external stakeholders to align programs with state and federal requirements, support quality improvement, and advance innovation. Represent the agency at state and national meetings, task forces, legislative activities, and collaborative partnerships to promote evidence-based care and strengthen agency outcomes.
** Clinical Authority and Licensure**:
Exercise independent clinical judgment in medical determinations, appeals, and coverage decisions. Maintain a current Oklahoma MD or DO license as required to fulfill assigned responsibilities
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* Supervisory Responsibilities:

** This position supervises.
* A bachelor’s degree in public health or health related degree, business administration or a closely related…