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St. Joseph Regional Medical Center

Lewiston, Idaho

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Kindred Hospitals

Santa Ana, California

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Towson, Maryland

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EDINBURG, Texas

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Pediatrix Medical Group

Snellville, GA, USA

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Akron Children's

Boardman, Ohio

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Baltimore, Maryland

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Houston, Texas

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LifeStance Health

Newton, MA

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Killeen, Texas

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Houston, Texas

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Shawnee Mission, Kansas

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St. Joseph Regional Medical Center

Lewiston, Idaho

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LifeStance Health

Needham, MA

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University of Maryland Medical System

Glen Burnie, Maryland

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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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