Chief Medical Officer

Full Job Description

The Chief Medical Officer (CMO) serves as the OPM resident medical expert, with national Healthcare and Insurance (HI) program responsibilities encompassing the insurance industry, health policy, population health, benefits design, standards of care, quality improvement, and regulatory initiatives.

Candidates should be committed to improving the efficiency of the Federal government, passionate about the ideals of our American republic, and committed to upholding the rule of law and the United States Constitution.

Candidates will not be hired based on their race, sex, color, religion, or national origin. All applicants must have 1 year of specialized experience.

Specialized experience is directly related to the duties and responsibilities of this position, referenced in the technical qualifications, that equipped the candidate with the scope and level of knowledge, skills, and abilities to successfully perform the work.

Eligibility will be based upon a clear showing that the applicant has had professional training and experience of the scope, level and quality sufficient to carry out the responsibilities of the position effectively.

To meet the minimum qualification requirements for this position, you must show that you possess the Senior Professional Qualifications (SPQs) and Mandatory Technical Qualifications (MTQs) related to this position within your resume - NOT TO EXCEED 2 PAGES.

Resumes over the 2-page limit, will not be reviewed beyond page 2 or may be disqualified.

Your resume should include examples of experience, education, and accomplishments applicable to the qualification(s).

If your resume does not reflect demonstrated evidence of these qualifications, you may not receive consideration for the position.

MANDATORY TECHNICAL QUALIFICATIONS (MTQs): Your resume should demonstrate accomplishments that would satisfy the mandatory technical qualifications.

Clinical knowledge and experience/expertise in medical leadership within the health policy/health management sphere.

Possesses both medical knowledge and an understanding of healthcare benefits management and delivery systems.

Board certified or Board-eligible specialist in at least one specialty recognized by the American Board of Medical Specialties (ABMS) or the American Osteopathic Association, as applicable DESIRABLE TECHNICAL QUALIFICATION (DTQ) (OPTIONAL): Prior leadership as a health plan, medical or pharmacy benefits management or experience with health systems.

Exhibit an understanding of Federal health benefits programs, pertinent laws regulations, claims dispute procedures, OPM precedent decision, and carrier interpretations.

SENIOR PROFESSIONAL QUALIFICATIONS (SPQs): In addition to the Mandatory Technical Qualification requirements listed above, all applicants will be assessed against the following Senior Professional Qualifications (SPQs): Partnering: Ability to develop networks and build alliances, engage in cross-functional activities; collaborate across boundaries, and find common ground with a widening range of stakeholders.

Utilize contacts to build and strengthen internal support bases.

External Awareness: Demonstrated experience in understanding local, national, and international policies and trends that affect the organization and shape stakeholders' views; is aware of the organization's impact on the external environment.

Communication: Ability to make clear and convincing oral presentations to individuals or groups; listen effectively and clarify information as needed; facilitate an open exchange of ideas and foster an atmosphere of open communication.

Ability to express written facts and ideas in a clear, convincing and organized manner. You must meet all qualification requirements by the closing date of this announcement.

Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religious; spiritual; community, student, social).

Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment.

You will receive credit for all qualifying experience, including volunteer experience. Major Duties:

If selected, you will be responsible for: Staying abreast of new clinical guidelines, preventive care recommendations, treatments, devices and procedures for possible incorporation or inclusion into HI programs.

Identifying innovations in public and private-sector health delivery, finance, and payment models which could reduce healthcare costs and improve healthcare quality and patient outcomes.

Highlighting best practices for incorporation into HI publications, guidance, and educational sessions.

Collaborating closely with the Chief Pharmacy Officer on matters pertaining to prescription drug coverage and formulary structure.

Contributes substantially to the development of OPM's annual Call Letter, Carrier Technical Guidance, Annual Reports, and Automated Data Collection (preparation, analysis, and interpretation).

Maintaining a rigorous evidence-based process to inform HI benefit designs and coverage determinations.

This process identifies new treatments or procedures that transition from experimental or investigational to standard of care, as well as periodically reviewing existing coverage parameters for currency.

Consulting and assisting Federal Employee Health Benefits (FEHB), Postal Service Health Benefits (PSHB), and Federal Employee Dental and Vision Insurance Program (FEDVIP) contracting groups in ensuring that carrier benefit proposals are responsive to OPM requirements as needed.