Regional Medical Director- (Nashville,TN)

Health Care Service Corporation•Nashville, TN

3d•$191,500 - $355,600•Remote

About The Position

At CareAllies, employees are described as the cornerstone of the business and the foundation of its success. The company offers curated development plans to foster employee growth and fulfilling careers. The Regional Medical Director is responsible for assigned aspects of medical policies and programs, conducts medical reviews, and interacts with provider communities in assigned areas. The role provides advanced clinical leadership across medical management programs, integrating traditional utilization review with population health, value-based care, and provider-performance initiatives. It aligns medical policy expertise with clinical strategy to influence quality, Stars-related performance, affordability, risk adjustment accuracy, and market-level outcomes. The position may be performed remotely from anywhere within the continental United States, excluding California, New York, Alaska, and Hawaii. The posting also identifies Nashville, Tennessee, as the remote work location.

Requirements

Be a physician with a current and unrestricted physician license in a U.S. state or territory.
Maintain board certification as an M.D. or D.O. through a specialty board approved by the American Board of Medical Specialties or the Advisory Board of Osteopathic Specialists, as applicable.
Have 5 years of clinical experience.
Have analytical and communication skills.
Have strategic thinking skills.

Nice To Haves

Ability to travel.
3 years of managed care experience.
Experience with an IPA (independent Physician Association), MSO, or Value Based Enablement Organization.
Advanced skills in clinical interpretation, communication, data-driven strategy, and collaborative leadership.
Experience with Stars performance, risk adjustment education, or provider engagement.
Experience in matrixed environments and cross-functional clinical leadership.

Responsibilities

Manage assigned aspects of medical policies and programs.
Perform medical reviews.
Interact with provider communities in assigned areas.
Provide advanced clinical leadership across medical management programs.
Integrate traditional utilization review with population health, value-based care, and provider-performance initiatives.
Use medical policy expertise and clinical strategy to influence quality, Stars-related performance, affordability, risk adjustment accuracy, and market-level outcomes.