Medical Director

Spectrum Healthcare Resources • Las Vegas, NV

10d • Remote

About The Position

Spectrum Healthcare Resources is excited to offer a potential career opportunity for a Behavioral Health Medical Director supporting the TriCare/Department of Defense and Community Care Network/Department of Veterans Affairs. This remote-based civilian position is an outstanding chance to make a meaningful contribution to the healthcare of veterans and military beneficiaries while benefiting from work-life flexibility, professional collaboration, and impactful leadership. Join us in leading high-quality care initiatives for those who have served our country, with a focus on system-wide clinical improvement, peer collaboration, and mission-driven support!

Requirements

• Doctor of Medicine (MD) or Doctor of Osteopathy (DO) from an accredited medical school.
• Active, unrestricted license to practice medicine in the United States.
• Board certification or board eligibility through a recognized specialty board.
• U.S. Citizenship.
• Favorable background investigation through the Department of Defense (DoD).
• Minimum of 5 years of medical practice experience.
• 3+ years of experience in managed care environments.

Nice To Haves

• Experience working with TRICARE, Veterans Affairs, or other federal health plans.
• Advanced degree in management (MPA, MBA, MHA, MPH).
• Corporate-level leadership experience.
• Experience using InterQual and/or similar evidence-based criterial to assess medical interventions, procedures and treatments.

Responsibilities

• Provide program-wide clinical guidance across multiple medical management domains including Utilization Management, Case Management, Quality, and Public Health.
• Lead and participate in quality committees and collaborative safety initiatives.
• Review member cases for appropriateness and quality of care; document findings in CareRadius and other health systems.
• Conduct peer-to-peer discussions with network providers and internal stakeholders.
• Develop and implement corrective action plans related to clinical quality or provider performance.
• Collaborate closely with TriWest teams such as Clinical Operations, Data Analytics, and General Counsel.
• Provide clinical expertise on new technologies, treatment protocols, and population health initiatives.
• Interact with veterans and beneficiaries to support satisfaction and outcomes.
• Stay current with required licensure, board certification, and federal medical standards.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Education Level: Ph.D. or professional degree