ProgenyHealth is a leading national, tech-enabled women's healthcare company dedicated to Maternity and NICU Care Management. We serve women, infants, and families from conception and pregnancy to postpartum and parenting, with special expertise in managing premature and complex births and resulting NICU admissions. With more than 20 years of experience, our board-certified physicians, nurses, social workers, and others improve health outcomes, enhance the member and provider experience, and lower the overall cost of care.

Position Summary:

The Chief Medical Officer will be joining a company passionate about supporting individuals and their families throughout the maternity and NICU journey to measurably increase enrollment and engagement, drive improvements in health outcomes, champion high quality, effective healthcare and optimize maternal and infant health economics. The right individual for this role will be someone who demonstrates an unwavering commitment to our core values and integrates them into every aspect of their work—bringing purpose, integrity, and collaboration to their daily decisions—while thriving in a fast-paced environment. 

The day-to-day responsibilities of this role include leading the ProgenyHealth Medical Management program, with accountability for the performance and outcomes of the Clinical Operations Department—including Utilization Management and Case Management functions—in close partnership with the SVP of Clinical Operations. The role also encompasses oversight of the Medical Director team and active collaboration with the Quality and Payment Validation (PVA) teams to ensure clinical excellence, operational efficiency, and alignment with organizational goals.

The ideal candidate is a metrics-driven, detail-oriented leader who can confidently analyze, interpret, and articulate data to demonstrate the effectiveness and impact of our clinical management programs. S/he will play a pivotal role in achieving strategic growth objectives across their teams and the broader organization. As a key partner to our Growth team, the CMO must be adept at representing ProgenyHealth externally, speaking with clarity and conviction about our outcomes and impact in meetings with current and prospective clients, as well as at industry events. This role also requires close collaboration with Product Management to inform product strategy, respond to market trends, and apply evidence-based insights to enhance product performance and quality.

Candidate must be humble and mission-driven, dedicated to supporting a stellar internal culture as well as working to provide the highest quality of service to the families we serve. ProgenyHealth’s CMO will be a decisive and resourceful problem-solver, capable of navigating complexity and ambiguity with confidence, making critical decisions with autonomy, knowing when to seek CEO or other executive team member input, as appropriate.

Candidates should be a strong communicator, collaborator, and passionate about the prospect of working across all levels of the business to drive results.

Responsibilities Include:

• Maintains and oversees the NICU Utilization Management (UM), NICU & Maternity Case Management (CM) and Quality Management (QM) Programs and monitors adherence and compliance by reviewing and analyzing company data and dashboards to measure effectiveness. Must have extensive experience monitoring and refining key performance indicators and dashboards of the business.
• Builds customer loyalty through data-driven insights and compelling demonstration of program value, while cultivating trusted relationships with key customer executives to reinforce strategic alignment and long-term partnerships. Supports the preparation, evaluation, and presentations of client program results at periodic client meetings, as needed.
• Engages and builds relationships with payer medical directors as well as hospital NICU teams, outpatient obstetric clinicians, and community partners as needed.
• Oversee the integrity and continued evolution of ProgenyHealth’s technology platform, ensuring that clinical algorithms and underlying data assets are current, evidence-based, and periodically reviewed to support optimal clinical program performance and innovation.
• Provides oversight of external publications that highlight ProgenyHealth’s medical management results, ensuring clinical accuracy, data integrity, and alignment with the company’s mission and brand voice.
• Works in close partnership with the SVP of Clinical Operations to ensure best-in-class training programs for all clinical staff, robust clinical oversight, and consistent monitoring of staff performance—driving excellence, accountability, and alignment with ProgenyHealth’s clinical quality benchmarks and job performance expectations.
• Will assist with the implementation and successful launch of new clients, new product lines, and/or technologies, as needed, to keep our program cutting edge and highly innovative in the marketplace.
• Oversight of ProgenyHealth’s Medical Director team to ensure fair and consistent medical necessity decision making by applying approved criteria and guidelines, including providing guidance as needed.
• Improves workflow and processes to be more efficient and effective in the delivery of ProgenyHealth services to its clients.
• Responsible for our continued successful accreditation by URAC and NCQA, as well as oversight of all State, Federal and Client standards/regulations necessary for ProgenyHealth to provide our services to our customers. 
• Leads the Medical Advisory Board and /Quality Improvement Committee and manages relationships with members that include practicing physicians across the US.
• Oversight and management of Quality-of-Care issues.

• MD/DO degree and Board-Certified in Neonatology, Obstetrics, MFM, or Pediatrics is required. Experience or deep interest in Maternal & Infant Health desired.
• MPH, MBA or MHA degree preferred
• Minimum of 5 years clinical practice experience after residency
• Minimum of 7-10 years in managed care with health plans preferred, or value-based care delivery or payvider models including 5+ years in a Senior/Executive leadership role overseeing UM/CM functions. 
• Proven track record of engaging with payer clinical executives as well as hospital NICU teams, outpatient obstetric clinicians, and community partners across behavioral health and social determinants of health
• Knowledge of NICU billing and claims is highly desirable
• Experience in Tableau and other standard reporting tools a plus
• Experience in UM/CM/QM management and the maintenance of URAC & NCQA accreditation strongly preferred. 
• Understanding of clinical literature in the maternal and infant health arenas, with familiarity in clinical trial design preferred.
• Humble player-coach who can roll up one’s sleeves and collaborate across all levels of an organization. 
• Mission-driven executive with a desire to improve the health outcomes of all pregnant moms and their newborns, including high-risk neonates 
• Must be willing to travel to company and/or client meetings, trade shows, etc. as business needs dictate. 
• Must have excellent computer skills and be proficient in Microsoft Office especially Excel.
• Must possess an active, unrestricted license to practice medicine. Must be willing & eligible to obtain licensure in additional states based on business needs.

Benefits

Some of the benefits we offer our team are:

• Paid Time Off
• Paid Parental Leave
• Medical, dental, vision benefits
• 401K with company match
• Short- and Long-Term Disability
• Group Life Insurance
• Tuition reimbursement

ProgenyHealth positively recruits people from diverse backgrounds, including individuals with disabilities - if you need an accommodation to interview, please contact us by email: careers@progenyhealth.com