Medical Director (MD)

Central California Alliance for Health (Remote)•Hollister, CA

3d•Hybrid

About The Position

We have an opportunity to join the Alliance as the Medical Director (MD). This is a hybrid position with the expectation to work in our service area(s) 2-3 days per month. The Alliance service area includes Merced, Santa Cruz, Monterey, San Benito, and Mariposa counties. Reporting to the Chief Medical Officer, this position: Provides clinical leadership within one or more of the Health Services functional areas, such as Utilization Management, Quality Improvement and Population Health, Pharmacy, Care Management, and Enhanced Health Services Develops and improves relationships with internal and external stakeholders, including the professional medical community, and maintains and enhances communications with similar Health Plan organizations Participates in all aspects of regulatory compliance related to Health Services functions THE IDEAL CANDIDATE Enjoys a fast-paced, demanding environment that requires critical thinking to develop and implement effective solutions in a timely manner Is dedicated to providing strategic clinical leadership for Medicaid populations, ensuring high‑quality, equitable care while integrating social determinants of health into program and policy decisions Works with a broad and diverse group of stakeholders to problem-solve and build innovative programs Has the latitude to think broadly, make operational and strategic decisions, and oversee the implementation and continuous process improvement related to key internal and external priorities Leverages clinical informatics experience to interpret data, guide program design, and support technology-enabled care delivery

Requirements

Knowledge of: The methods of designing, operationalizing, evaluating, and iterating workflows and programs
Data collection and management practices, as related to utilization and quality of medical care
The principles and practices of program development and project management
Applying and promoting change management principles
The Managed care, Medi-Cal, Medicaid, and Medicare programs and healthcare regulatory processes
Ability to: Independently navigate complex systems to effectively and efficiently implement new programs in a timely manner
Communicate clearly and consistently and work collaboratively with stakeholders and partners, such as patients, community-based organizations, and healthcare providers
Evaluate, qualitatively and quantitatively, a broad variety of programs and processes and use these evaluations to ensure ongoing quality improvement
Analyze issues and think critically to ensure success in leading system change, make informed operational and strategic decisions, and oversee implementation and continuous process improvement related to key internal and external priorities
Manage multiple projects simultaneously, organize work, and achieve goals and timelines
Education and Experience: Doctor of Medicine or Doctor of Osteopathy from an accredited medical school and a current active and unrestricted license to practice medicine issued by the State of California, Board certification in a specialty recognized by the American Board of Medical Specialties, and a minimum of three years of experience working in medical programs administration, including experience with the peer review process; or an equivalent combination of education and experience may be qualifying.

Responsibilities

Provides clinical leadership within one or more of the Health Services functional areas, such as Utilization Management, Quality Improvement and Population Health, Pharmacy, Care Management, and Enhanced Health Services
Develops and improves relationships with internal and external stakeholders, including the professional medical community, and maintains and enhances communications with similar Health Plan organizations
Participates in all aspects of regulatory compliance related to Health Services functions