3h ago

Medicare Medical Director (MD)

Merced County, California; Mariposa County, California; Monterey County, California; San Benito County, California; Santa Cruz County, California
full-timedirector HybridHealth Insurance

Description

You will serve as the clinical subject matter expert for the Medicare Dual Eligible Special Needs Plan (D-SNP), providing specialized leadership across Health Services functions, developing stakeholder relationships, and ensuring regulatory compliance. This role involves strategic decision-making and overseeing continuous process improvement.

Requirements

  • Knowledge of Medicare population needs and Medicare Plan administration
  • Knowledge of Medicare D-SNP program, CMS STARS, and managed care
  • Ability to provide clinical oversight and leadership of D-SNP program
  • Ability to analyze issues and make informed operational and strategic decisions
  • Ability to interpret regulations and legal/contractual language

Responsibilities

  • Act as clinical subject matter expert for Medicare D-SNP
  • Provide clinical D-SNP leadership across Health Services
  • Develop relationships with internal and external stakeholders including the medical community
  • Participate in regulatory compliance related to D-SNP and Health Services
  • Oversee implementation and continuous process improvement of key priorities
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