FREE ACCESS
5,000–10,000 jobs/day
See all jobs on JobTailor
Search thousands of fresh jobs every day.
Discover
- Fresh listings
- Fast filters
- No subscription required
Create a free account and start exploring right away.
About the role
Key responsibilities & impact- Set clinical strategy and lead the Utilization Management organization.
- Oversee the integration of medical doctors and registered nurses in UM across Medicaid and Medicare.
- Provide leadership in risk management, grievance and appeals, clinical contracting, vendor management, and UM dental review.
- Ensure the clinician’s perspective is central to organizational decision-making.
- Leverage analytics to inform strategy and performance improvement.
- Sponsor the development of clinical talent and leadership pipeline.
Requirements
What you’ll need- MD/DO
- Current Board Certification
- Minimum 10 years of combined leadership and/or UM experience
- Passion for improving Star Ratings, review consistency, and health outcomes
- Deep knowledge of medical, clinical, and behavioral science underpinning UM
- Strong interpersonal, leadership, and business acumen
- Proven ability to drive cross-functional results and champion clinical perspectives.
Benefits
Comp & perks- Health insurance
- 401(k) matching
- Flexible work hours
- Paid time off
- Remote work options
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
Utilization Managementrisk managementclinical contractingvendor managementanalyticsperformance improvementclinical talent development
Soft Skills
leadershipinterpersonal skillsbusiness acumencross-functional collaborationchampioning clinical perspectives
Certifications
MDDOBoard Certification