Vice President, Health Services Medical Management
About The Position
The Vice President, Medical Management provides executive leadership, strategic direction, and operational oversight for AltaMed’s Medical Management functions, including Utilization Management (UM), Care/Complex Case Management (CM), and related clinical management programs. The VP develops and executes enterprise strategies to promote high-quality, cost-effective, evidence-based care while ensuring compliance with regulatory, accreditation, health plan, and contractual requirements. The VP collaborates with executive and clinical leadership to drive performance improvement, population health initiatives, value-based care strategies, and clinical integration across the organization. The position leads multiple levels of management and senior clinical professionals and serves as a key advisor to executive leadership on medical management strategy.
Requirements
- Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) from an accredited institution.
- Current unrestricted California physician license.
- Current unrestricted DEA registration.
- Board Certification in an ABMS- or AOA-recognized specialty.
- At least 10 years of progressive physician leadership experience in managed care, integrated delivery systems, or health plans.
- At least 7 years leading Medical Management, Utilization Management, Care Management, Population Health, or related clinical operations.
- Experience leading multidisciplinary teams through multiple layers of management.
- Experience with delegated managed care, value-based care, quality improvement, utilization review, and regulatory compliance.
Nice To Haves
- Experience with Medi-Cal, Medicare Advantage, NCQA, DMHC, CMS, and DHCS requirements.
- Federally Qualified Health Center (FQHC) or integrated delivery system experience.
Responsibilities
- Provide executive leadership, strategic direction, and operational oversight for Utilization Management, Care/Complex Case Management, and related clinical management programs.
- Develop and execute enterprise strategies that promote high-quality, cost-effective, evidence-based care.
- Ensure compliance with regulatory, accreditation, health plan, and contractual requirements.
- Collaborate with executive and clinical leadership to drive performance improvement, population health initiatives, value-based care strategies, and clinical integration.
- Lead multiple levels of management and senior clinical professionals.
- Advise executive leadership on medical management strategy.
Benefits
- Medical, dental, and vision insurance
- 403(b) retirement savings plans with employer matching contributions
- Flexible Spending Accounts
- Commuter Flexible Spending
- Career advancement and development opportunities
- Paid Time Off and holidays
- Paid CME days
- Malpractice insurance and tail coverage
- Tuition Reimbursement Program
- Corporate Employee Discounts
- Employee Referral Bonus Program
- Pet Care Insurance
- May qualify for discretionary bonuses or incentives
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What This Job Offers
Job Type
Full-time
Career Level
Executive
Education Level
Ph.D. or professional degree
