Full-Time

Chief Medical Officer

Posted on 5/9/2026

Availity

Availity

1,001-5,000 employees

Revenue cycle management and clearinghouse platform

No salary listed

No H1B Sponsorship

Remote in USA

Remote

Category
Medical, Clinical & Veterinary (2)
,
Required Skills
Data Science
Requirements
  • 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 information technology, 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.
Responsibilities
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
Desired Qualifications
  • Experienced working in the Healthcare Technology space.
  • Strong understanding of value-based care and population health models.

Availity provides revenue cycle management and clearinghouse services for the healthcare sector. It offers a platform with a multi-payer portal that enables real-time collaboration among providers, payers, and other stakeholders. Core features include eligibility and benefits verification, claims management, and authorizations, all accessible through a subscription-based platform. The system helps healthcare organizations streamline administrative tasks in the revenue cycle, reducing time and costs and allowing providers to focus more on patient care. Unlike single-payer or standalone systems, Availity combines multiple payers and services in one platform, enabling integrated workflows across the healthcare payment process. The goal is to improve efficiency and financial performance for healthcare providers and payers by simplifying and speeding up administrative processes.

Company Size

1,001-5,000

Company Stage

N/A

Total Funding

N/A

Headquarters

Jacksonville, Florida

Founded

2001

Simplify Jobs

Simplify's Take

What believers are saying

  • CMS-0057-F Blueprint positions Availity for 25% payer compliance ahead of January 2027 deadline.
  • RevSpring PersonaPay integration on March 6, 2025, halves reconciliation time and boosts payments.
  • Abridge collaboration delivers real-time prior auth at point of conversation via ambient AI.

What critics are saying

  • Change Healthcare captures 40% more volume through aggressive pricing, eroding Availity share by Q1 2027.
  • Waystar undercuts Essentials Pro pricing by 25%, stealing 15-20% top clients via Epic integrations by mid-2027.
  • CMS-0057-F APIs enable FHIR bypass of Availity portal, slashing fees 60% as Epic embeds tools by 2028.

What makes Availity unique

  • Availity Essentials Pro integrates all-payer clearinghouse for claim scrubbing and denial prevention.
  • Availity Abrasion Index quantifies friction in prior auth, claims, and denials from 2026 research.
  • Availity Extend enables secure AI automation on network connecting 4,000 payers and 3.5 million providers.

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Benefits

Health Insurance

Dental Insurance

Vision Insurance

401(k) Retirement Plan

401(k) Company Match

Unlimited Paid Time Off

Paid Holidays

Wellness Program

Education Reimbursement

Paid Parental Leave

Company News

Abridge
Jan 12th, 2026
Abridge and Availity Collaborate to Redefine Payer-Provider Synergy at the Point of Conversation

Abridge and Availity collaborate to redefine payer-provider synergy at the point of conversation. Announcement: Abridge is collaborating with Availity, the nation's largest real-time health information network, to connect patients, providers, and payers at the point of conversation. The two companies are developing a first-of-its-kind prior authorization experience. This is just one component of a broader revenue cycle collaboration focused on bringing real-time intelligence to the point of conversation. Abridge AI Inc. is just getting started but the vision is bold: For patients: more transparency, reduced administrative delays. For clinicians: workflows designed to support payer determination closer to the visit. For payers: aligning utilization management with the clinician-patient conversation.

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Aug 26th, 2025
Delaware health info system partnership aims to provide higher quality medical record summaries

Delaware Health Information Network (DHIN) has partnered with Availity, to improve Continuity of Care Documents (CCDs) shared across DHIN's network.

PR Newswire
Mar 6th, 2025
Revspring And Availity Expand Partnership With Integration Of Revspring'S Personapay™ And Availity Essentials Pro™

Availity's customers gain a more robust, full-service digital revenue cycle solution, including RevSpring's billing engagement and merchant servicesNASHVILLE, Tenn. and JACKSONVILLE, Fla., March 6, 2025 /PRNewswire/ -- RevSpring, the leading provider of healthcare engagement and payment solutions, and Availity, the nation's largest payer, provider and partner network, today announced a significant expansion of their long-time partnership. RevSpring's market leading PersonaPay™ patient payments portal—awarded Best in KLAS® for Patient Financial Engagement—and merchant services are now integrated with Availity Essentials Pro™ revenue cycle management solution. Availity customers gain streamlined access to a more robust, full-service solution to drive increased payments, faster and more efficient patient payments and processing, and, ultimately, higher return on investment.PersonaPay facilitates built-in intelligence to empower patients to pay precisely what they can, when they should from anywhere. It automatically personalizes payment options, such as pay in full, payment plans, financial assistance or patient financing to fit each patient's individual need and ability to pay. Once a payment is made, RevSpring's Merchant Services then seamlessly processes and creates reconciliation reporting that cuts manual reconciliation in half and eliminates the need for multiple vendors to process any payments from a RevSpring payment solution."RevSpring and Availity have successfully partnered to deliver value to providers and their patients for more than a decade

RevSpring
Mar 6th, 2025
RevSpring and Availity Expand Partnership with Integration of RevSpring's PersonaPay(TM) and Availity Essentials Pro(TM)

RevSpring's market leading PersonaPay(TM) patient payments portal - awarded Best in KLAS(R) for Patient Financial Engagement - and merchant services are now integrated with Availity Essentials Pro(TM) revenue cycle management solution.