3h ago

Medical Director (MD)

Merced County, Monterey County, Santa Cruz County, San Benito County, Mariposa County
full-timedirector HybridHealthcare

Description

You will provide clinical leadership within Health Services functions like Utilization Management, Quality Improvement, and Care Management. You'll develop relationships with stakeholders and ensure regulatory compliance, focusing on Medicaid populations and integrating social determinants of health.

Requirements

  • Knowledge of designing, operationalizing, evaluating, and iterating workflows and programs
  • Knowledge of data collection and management practices for utilization and quality of medical care
  • Knowledge of Managed care, Medi-Cal, Medicaid, and Medicare programs and healthcare regulatory processes
  • Ability to independently navigate complex systems to implement new programs
  • Ability to communicate clearly and collaborate with stakeholders

Responsibilities

  • Provide clinical leadership for Utilization Management, Quality Improvement, Population Health, Pharmacy, Care Management, or Enhanced Health Services
  • Develop and improve relationships with internal and external stakeholders, including the professional medical community
  • Maintain and enhance communications with similar Health Plan organizations
  • Participate in regulatory compliance related to Health Services functions
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