Massachusetts Licensed Medical Director

Job Summary

A company is looking for a Health Plan Medical Director to lead medical management and clinical services operations.

Key Responsibilities

• Collaborates with various teams to enhance quality and cost efficiency of care
• Partners with clinical leaders to manage medical service expenditures within budget
• Develops clinical programs and policies while overseeing disease management initiatives

Required Qualifications

• Physician License for Massachusetts or willingness to obtain one
• 3-5 years of experience in a Health Plan setting
• Experience in utilization management and health plan quality
• Knowledge of compliance requirements for Medicare, Medicaid, and NCQA
• Ability to build relationships and promote diversity, equity, and inclusion