[Hiring] Chief Medical Officer @Availity

Role Description

As Availity’s Chief Medical Officer (CMO), you will be the company’s senior clinical voice—guiding how our platform, workflows, and next-generation innovations show up in the real world of care delivery and reimbursement. Reporting to the COO, you will partner across Product, Technology, Data, Legal, and Commercial teams to embed clinical integrity into our large-scale, network-based solutions, building trust with health systems and payers and accelerating impact for patients and providers.

The ideal CMO is a clinically credible systems-thinker who understands that small clinical decisions—when scaled across millions of transactions—carry significant impact. They balance innovation with stewardship and bring confidence to Availity’s role as a trusted advisor to both sides of the network.

Location: Remote, US

Why you want to work on this team:

• Passionate about influencing workflows tied to prior auth, utilization management, clinical data exchange, and revenue-cycle steps that directly affect patient access and provider burden—at platform scale.
• Excited about helping a fast-growing healthcare technology company move faster (automation/AI-enabled workflows) while also protecting patients, providers, and the business by managing clinical, ethical, and reputational risk.

Qualifications

• Medical degree required (MD or DO).
• Extensive experience working with health systems and health plans.
• Deep understanding of payer-provider workflows, clinical policy, and utilization management.
• Experience partnering with technology, data, or analytics organizations at enterprise scale.
• Strong executive presence and ability to influence without direct clinical operations ownership.
• Background in health IT, healthcare networks, or enterprise healthcare platforms.
• Experience with clinical decision support, utilization management, or AI-enabled healthcare workflows.
• Familiarity with value-based care and population health models.
• MBA, MPH, or clinical informatics experience.

Requirements

• Clinical Oversight & Governance
• Providing clinical leadership across Availity’s platform, including solutions that influence:
  • Prior authorization
  • Utilization management
  • Clinical data exchange
  • Revenue cycle and administrative workflows connected to patient care
• Ensuring clinical logic, policies, and automation align with standards of care and payer medical policy frameworks.
• Identifying and mitigating clinical, ethical, and reputational risk associated with scaled automation and AI-enabled workflows.
• Partnering with Legal, Compliance, and Security teams on clinical governance and regulatory considerations.
• Product, Data & AI Partnership
• Acting as the senior clinical partner to Product, Engineering, and Data Science.
• Validating clinical assumptions embedded in business rules, analytics, and AI models.
• Ensuring solutions are usable, defensible, and trusted in real provider and payer environments.
• Payer & Health System Engagement
• Serving as Availity’s primary clinical executive for enterprise customers.
• Supporting payer medical leaders, provider executives, and clinical operations teams in adopting Availity solutions.
• Partnering with Sales, Growth, and Customer teams in complex clinical discussions, evaluations, and implementations.
• Aligning Availity’s value messaging to payer and provider priorities: quality, efficiency, administrative burden reduction, and trust.
• Outcomes, Value & Credibility
• Defining clinical success criteria for solutions that support payer-provider interaction and decision-making.
• Ensuring clinical claims are accurate, defensible, and supported by evidence or operational logic.
• Supporting outcome measurement tied to efficiency, quality, and reduced friction in healthcare delivery.
• Thought Leadership & Internal Enablement
• Representing Availity as a credible, clinically grounded leader in the healthcare ecosystem.
• Educating internal teams on how clinical practice, payer policy, and operational realities intersect.
• Helping position Availity as a trusted, neutral intermediary in healthcare collaboration.

Benefits

• Competitive salary and bonus structure.
• Generous HSA company contribution.
• Healthcare, vision, and dental benefits.
• 401k match program available from day one.
• Unlimited PTO for salaried associates + 9 paid holidays.
• Hourly associates start at 19 days of PTO with the same holiday benefits.
• Reimbursement up to $250/year for gym memberships, racing events, weight management programs, etc.
• Education reimbursement available.
• Paid Parental Leave for both birth and adoptive parents.
• Opportunities to engage with community organizations through volunteer efforts.