State Licensed VP Medical Director

Job Summary

Leading clinical programs remotely, the full-time State Licensed VP Medical Director will manage Health Plan Medical Directors and provide clinical support for Health Management, Utilization Management, and Quality teams while driving the development and delivery of evidence-based care management programs.

Key responsibilities

• Achieves clinical outcomes and affordability goals in partnership with leadership to support health plan strategy
• Ensures compliance with government regulations and manages clinical appeals and grievances
• Develops strategies for medical expense management and quality improvement to enhance care for populations served

Required qualifications

• Medical Degree (MD or DO) from an accredited medical school
• Board Certification in a relevant discipline or specialty
• 10+ years of clinical practice experience, including leadership roles in Health Plans
• HMO/Managed Care experience, particularly in Utilization and Quality Program management
• Deep knowledge of healthcare systems and managed care concepts