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# Chief Medical Officer (CMO) with a Health Plan – St. Louis, MO


Role Overview for Chief Medical Officer (CMO) with a Health Plan – St. Louis, MO
JRG Partners is proud to lead the executive search for a transformative and visionary Chief Medical Officer (CMO) on behalf of a premier, mission-driven health plan located in the vibrant heart of St. Louis, Missouri. This is a career-defining opportunity for a distinguished physician leader to shape the future of healthcare for a diverse and growing member population.
The CMO will serve as the senior clinical executive for the organization, providing strategic direction, leadership, and oversight for all clinical and quality-related functions. Reporting directly to the Plan President/CEO, this role is a critical component of the executive leadership team, responsible for driving the organization’s clinical vision and ensuring the delivery of high-quality, cost-effective, and member-centric care.
The ideal candidate will be a forward-thinking leader with a deep understanding of the complexities of the modern healthcare landscape, including managed care, value-based payment models, and population health management. You will be the clinical voice of the organization, championing a culture of continuous quality improvement, clinical innovation, and physician engagement. This role demands a unique blend of clinical expertise, business acumen, and inspirational leadership.
You will be tasked with not only overseeing current clinical operations but also with anticipating future trends and positioning the health plan for long-term success in an ever-evolving regulatory and market environment. Your leadership will directly impact the health and well-being of thousands of members across the region, making this a profoundly rewarding and impactful position.
As the CMO, you will be instrumental in developing and nurturing strong, collaborative relationships with our network of providers, hospital systems, and community partners. You will guide the organization’s transition towards more integrated and value-based care models, leveraging data analytics and technology to improve health outcomes, enhance the member experience, and manage the total cost of care. If you are a passionate and strategic physician executive dedicated to improving health equity and driving excellence in a managed care setting, we invite you to explore this exceptional opportunity to lead and innovate in St. Louis.
Key Responsibilities of Chief Medical Officer (CMO) with a Health Plan – St. Louis, MO
The Chief Medical Officer will have a broad and strategic set of responsibilities, encompassing clinical leadership, quality assurance, and operational excellence. Your duties will be pivotal in ensuring the health plan meets its clinical and financial objectives.
Clinical Strategy and Vision
Develop, implement, and refine the overarching clinical strategy for the health plan, ensuring alignment with the organization’s mission, vision, and strategic goals. Provide executive leadership for all clinical departments, including Utilization Management, Case Management, and Disease Management.
Quality Improvement Leadership
Spearhead all clinical quality improvement initiatives. This includes direct oversight of programs designed to enhance performance on key metrics such as HEDIS® (Healthcare Effectiveness Data and Information Set), Medicare STAR Ratings, and state-specific quality measures. Ensure continuous readiness for NCQA accreditation and other regulatory audits.
Utilization and Care Management
Oversee the development and execution of effective utilization management (UM) and care management (CM) programs. Ensure that medical necessity reviews, prior authorizations, and appeals processes are timely, efficient, and consistent with clinical best practices and regulatory requirements.
Provider Network Collaboration
Work closely with the provider relations and network management teams to foster a collaborative, high-performing provider network. Lead clinical engagement efforts, promote evidence-based practices, and serve as the primary clinical liaison to key physician groups and health systems.
Population Health Management
Design and implement innovative population health strategies to address the specific needs of diverse member populations, including Medicare, Medicaid, and Commercial lines of business. Utilize data analytics to identify high-risk cohorts and develop targeted interventions to improve health outcomes and reduce health disparities.
Medical Policy and Procedure
Direct the development, implementation, and regular review of all clinical policies, procedures, and medical guidelines. Ensure all policies are evidence-based, compliant with current standards of care, and support the delivery of appropriate, high-quality services.
Executive Leadership and Mentorship
Serve as an active and influential member of the senior executive team, contributing to the overall strategic direction of the health plan. Mentor, guide, and develop a high-performing team of medical directors and clinical staff, fostering a culture of accountability, collaboration, and professional growth.
Financial Stewardship
Partner with the Chief Financial Officer (CFO) and analytics teams to manage medical costs and trends effectively. Provide clinical insights into medical budget forecasting, risk adjustment strategies, and the financial impact of clinical programs and value-based contracts.
Regulatory Compliance
Ensure all clinical operations are in full compliance with federal (CMS), state, and local regulations. Stay abreast of changes in healthcare legislation and policy and guide the organization in adapting its clinical strategies accordingly.
Innovation and Technology
Champion the evaluation and adoption of new clinical technologies, including telehealth, remote patient monitoring, and advanced data analytics platforms, to enhance care delivery and member engagement.
Requirements for the Chief Medical Officer (CMO) with a Health Plan – St. Louis, MO
We are seeking a highly qualified and experienced physician executive who meets the following criteria. The successful candidate will possess a strong foundation in clinical medicine combined with significant leadership experience in a managed care environment.
Medical Degree
Must possess a Medical Doctor (M.D.) or Doctor of Osteopathic Medicine (D.O.) degree from an accredited medical school.
Medical Licensure
An active, unrestricted license to practice medicine in the state of Missouri is required, or the ability to obtain one prior to commencement of employment.
Board Certification
Current board certification in a specialty recognized by the American Board of Medical Specialties (ABMS) or the American Osteopathic Association (AOA) is mandatory.
Executive Experience
A minimum of ten (10) years of progressive leadership experience within a health plan, managed care organization (MCO), or an integrated health system is required. At least five (5) of these years should be in a senior leadership role (e.g., Medical Director, VP of Clinical Affairs).
Clinical Practice Experience
A minimum of seven (7) years of direct patient care experience is strongly preferred to ensure a deep understanding of the physician and member perspective.
Managed Care Expertise
Demonstrated, in-depth knowledge of managed care principles across multiple lines of business, including Medicare Advantage, Managed Medicaid, and Commercial products. Proven success in managing quality improvement (HEDIS, STARS), utilization management, and population health programs.
Strategic and Financial Acumen
Strong business and financial acumen, with experience in medical cost management, budget development, and the implementation of value-based care models. Must possess the ability to think strategically and translate clinical concepts into actionable business plans.
Leadership and Communication Skills
Exceptional interpersonal, communication, and presentation skills. A proven ability to lead, influence, and build consensus among diverse stakeholders, including physicians, executives, and regulatory bodies.
Data-Driven Decision-Maker
Proficiency in using data and analytics to drive clinical decision-making, measure program effectiveness, and identify opportunities for improvement.
Location
The candidate must be willing to reside in the greater St. Louis, MO metropolitan area.
Benefits & Perks Offered
Our client offers a highly competitive and comprehensive executive benefits package designed to attract and retain top-tier talent. We believe in rewarding our leaders for their commitment to our mission and their contributions to our success.
Executive Compensation
A highly competitive base salary complemented by a significant annual performance-based bonus and a long-term incentive plan (LTIP).
Comprehensive Health and Wellness
Premier medical, dental, and vision insurance plans for you and your eligible dependents, along with a robust wellness program.
Retirement Savings
A generous 401(k) retirement plan with a substantial company match to help you secure your financial future.
Generous Paid Time Off
A competitive paid time off (PTO) package, including vacation, sick leave, and paid holidays, to support a healthy work-life balance.
Relocation Assistance
A comprehensive relocation package is available for qualified candidates and their families moving to the St. Louis area.
Professional Development
Ample support for continuing medical education (CME), professional association memberships, and executive leadership development programs.
Insurance and Protection
Company-paid life insurance, short-term disability (STD), and long-term disability (LTD) coverage.
Community Impact
The invaluable opportunity to make a tangible and lasting impact on the health and well-being of the community you serve.
How to Apply
This executive search is being conducted exclusively by JRG Partners. To express your interest in this confidential opportunity, please submit your curriculum vitae and a cover letter detailing your qualifications and leadership philosophy. All applications will be handled with the utmost discretion and confidentiality.
JRG Partners is a leader in retained executive search for the healthcare industry. We are committed to connecting exceptional leaders with transformative opportunities. To learn more about our expertise and how we build winning teams, please visit the page for JRG Partners’ Healthcare Executive Search team. We look forward to reviewing your application and discussing how your experience aligns with the strategic needs of our client.
Our client is an equal opportunity employer and is committed to creating a diverse and inclusive workplace. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.