Regional Medical Director

Health Care Service Corporation • Baltimore, MD

2d • $191,500 - $355,600 • Hybrid

About The Position

This position is responsible for assigned aspects of medical policies and programs. Performs medical reviews and interacts with the provider communities for assigned areas. Provides advanced clinical leadership across medical management programs, integrating traditional utilization review with strategic population health, value-based care, and provider-performance initiatives. Aligns medical policy expertise with forward-leaning clinical strategy to influence quality, Stars-related performance, affordability, risk adjustment accuracy, and market-level outcomes.

Requirements

• Physician with a current and unrestricted physician license in a state or territory of the United States.
• Maintain Board Certification as a M.D. or D.O. (by a specialty board approved by the American Board of Medical Specialties (doctors of medicine); or the Advisory Board of Osteopathic Specialists (doctors of osteopathic medicine).
• 5 years of clinical experience
• Analytical and communication skills
• Strategic thinking skills

Nice To Haves

• Ability to travel
• 3 years Managed Care experience
• IPA (independent Physician Association) MSO or Value Based Enablement Organization Experience
• 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

• Performs medical reviews and interacts with the provider communities for assigned areas.
• Provides advanced clinical leadership across medical management programs, integrating traditional utilization review with strategic population health, value-based care, and provider-performance initiatives.
• Aligns medical policy expertise with forward-leaning clinical strategy to influence quality, Stars-related performance, affordability, risk adjustment accuracy, and market-level outcomes.

Benefits

• health and wellness benefits
• 401(k) savings plan
• pension plan
• a minimum of 15 days’ of paid time off
• paid parental leave
• disability insurance
• supplemental life insurance
• employee assistance program
• paid holidays
• tuition reimbursement
• annual incentive bonus plan

What This Job Offers

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