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The City of Hoover

Hoover , Alabama

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Albany College of Pharmacy and Health Sciences

Albany, New York

Allan Hancock College

Santa Maria, California

New Mexico State University

Las Cruces, New Mexico

The Savannah Country Day School

Savannah, Georgia

University of California, Irvine

Irvine, California

Fairfield University

Fairfield, Connecticut

Eastern Michigan University

Ypsilanti, Michigan

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CHRISTUS Health

Shreveport, Louisiana

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University of Maryland Medical System

Bel Air, Maryland

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AdventHealth

Castle Rock, Colorado

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UCLA

Venice, California

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Vanderbilt Health

Nashville, Tennessee

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St. Joseph Regional Medical Center

Lewiston, Idaho

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UCLA

Santa Monica, California

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LifeStance Health

Timonium, MD

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LifeStance Health

Naperville, IL

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AdventHealth

Altamonte Springs, Florida

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Medical Director Health Plan
JOB SUMMARYResponsible for managing Health Plan medical costs and assuring appropriate health care delivery for plans and members. Is accountable to provide professional leadership and direction in the utilization/cost management (UM) and clinical quality improvement (QI) of the Health Plan, as measured by benchmarked UM and QI goals. Works collaboratively as a clinical resource to other plan functions that interface with medical management such as provider relations, member services, benefits, claims management, etc. Carries out medical policies at the Health Plan consistent with NCQA and other regulatory bodies.ESSENTIAL FUNCTIONS OF THE ROLEIdentify opportunities for corrective action plans to address issues and improve plan and network man


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