Job Summary
A company is looking for a Health Plan Medical Director.
Key Responsibilities
- Provide medical management leadership for clinical services operations and programs
- Collaborate with various teams to improve quality and cost efficiency of care
- Develop and oversee clinical programs and policies, ensuring compliance with regulatory requirements
Required Qualifications
- Physician License for Massachusetts or willingness to obtain one
- 3-5 years of health plan experience
- Prior experience with DSNP members, utilization management, and care management
- Experience with HEDIS/STARS and quality background preferred
- Ability to collaborate effectively with clinical and operational teams
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