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Medical Director – Population Health, Clinical Oversight
TranscarentMedical Director providing physician leadership focused on population health strategies at Transcarent. Ensures sound clinical models and risk management for high-cost claimants.
About the role
Key responsibilities & impact- Provide physician leadership for population health priorities, with a focus on high-risk and high-cost populations across lines of business.
- Ensure the clinical appropriateness of risk stratification and intervention approaches, informing where and how resources are deployed.
- Guide clinical priorities that improve outcomes, experience, and value across targeted populations, aligned to client and contractual goals.
- Provide physician oversight for high-cost claimants and stop-loss reporting where required for contractual, audit, or customer needs.
- Ensure clinical validity, accuracy, and consistency of external reporting and client deliverables.
- Partner with analytics teams to streamline and standardize reporting processes, reducing manual physician involvement over time while maintaining clinical integrity.
- Serve as the physician escalation point for complex, high-risk, or clinically ambiguous cases where physician input drives meaningful decisions or risk mitigation.
- Define and refine criteria for physician involvement so effort is focused on high-impact scenarios rather than broad retrospective review.
- Promote standards of practice, quality oversight, and exception-based engagement models that emphasize proactive, value-added physician review.
- Identify and eliminate low-value physician work through automation, delegation, and clearer protocols, in partnership with operations and product teams.
- Lead the transition from legacy case management support toward a focused, high-impact physician role concentrated on population health, governance, and critical escalations.
Requirements
What you’ll need- Education: Doctor of Medicine (MD) or Doctor of Osteopathy (DO) degree; current, unrestricted medical license in good standing. Board certification in an applicable specialty (e.g., Internal Medicine, Family Medicine, Emergency Medicine, or relevant subspecialty) required.
- 7+ years of clinical practice experience, with at least 3–5 years in a health plan, population health, accountable care, or value-based care setting.
- Demonstrated experience with population health management, high-cost claimant oversight, or utilization management programs.
- Prior leadership experience in a medical director or equivalent physician leadership role strongly preferred.
- Deep understanding of population health concepts, including risk stratification, targeted interventions, and measurement of clinical and financial outcomes across populations.
- Familiarity with high-cost claimants, stop-loss programs, and clinical risk management, including how clinical oversight influences contractual performance and client satisfaction.
- Experience in clinical governance and quality oversight, including setting clinical standards, review criteria, and escalation pathways for complex cases.
- Comfort working with analytics, reporting outputs, and data-driven decision-making in a clinical or operational context.
Benefits
Comp & perks- Competitive medical, dental, and vision coverage
- Competitive 401(k) Plan with a generous company match
- Flexible Time Off/Paid Time Off, 13 paid holidays
- Protection Plans including Life Insurance, Disability Insurance, and Supplemental Insurance
- Mental Health and Wellness benefits
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
population health managementrisk stratificationutilization managementclinical governancequality oversightdata-driven decision-makinghigh-cost claimant oversightstop-loss programsclinical risk managementmeasurement of clinical outcomes
Soft Skills
leadershipcollaborationcommunicationproblem-solvingstrategic thinkingclinical oversightproactive engagementanalytical thinkingdecision-makinginterpersonal skills
Certifications
Doctor of Medicine (MD)Doctor of Osteopathy (DO)current medical licenseboard certification in Internal Medicineboard certification in Family Medicineboard certification in Emergency Medicine