Medical Director

• Drive quality medicine and patient safety across hospitals
• Ensure consistent delivery of high-quality, evidence-based care
• Coach and develop Medical Directors through record reviews and real-time feedback
• Champion patient safety initiatives, including event reporting and improvement efforts
• Support adoption of new medical advancements and standards of care
• Oversee medical record quality, equipment standards, and clinical compliance
• Manage medical-related client concerns and board complaints
• Foster a culture of collaboration, accountability, and safety within the team
• Mentor and grow Medical Directors and veterinarians

Group Medical Director

• The Medical Director supervises and provides clinical oversight to staff/contract practitioners, psychiatrists, and medical professionals.
• Direct the day-to-day operations of the outpatient clinical programs.
• Ensure the productivity of the department and monitor individual staff performance to meet productivity standards.
• Responsible for the overall direction and management of outpatient clinical staff including selection, training and development, goal setting, evaluation, performance feedback, and ensuring a positive and respectful work environment.
• Provide administrative and clinical supervision of Program Managers and indirect supervision to all departmental staff.
• Monitor and maintain all client records in accordance with agency policies and procedures.
• Participate in utilization review functions associated with department.
• Recommend changes that would improve service delivery and implement changes and new programming as directed.
• Develop and maintain effective working relationships with all related state, community behavioral health, and contracting organizations.

• The Medical Director supervises and provides clinical oversight to staff/contract practitioners, psychiatrists, and medical professionals.
• Review and evaluate the treatment procedures and outcomes of the prescribers to ensure they are in accordance with provision of services and/or agency requirements.
• Ensure the quality of care given to our behavioral health clients is clinically appropriate and evidence based.
• Direct the day-to-day operations of the outpatient clinical programs.
• Ensure the productivity of the department and monitor individual staff performance to meet productivity standards.
• Responsible for the overall direction and management of outpatient clinical staff including selection, training and development, goal setting, evaluation, performance feedback, and ensuring a positive and respectful work environment.
• Provide administrative and clinical supervision of Program Managers and indirect supervision to all departmental staff.
• Development and implementation of policies and procedures for delivery of outpatient clinical programs according to the Arizona Practice Model.
• Maintain quality assurance of department's service delivery including clinical care and documentation.
• Monitor and maintain all client records in accordance with agency policies and procedures.
• Participate in utilization review functions associated with department.
• Recommend changes that would improve service delivery and implement changes and new programming as directed.
• Monitor the reporting of services, establish evaluation guidelines, and ensure that programmatic contract requirements are met.
• Provide community outreach.
• Develop and maintain effective working relationships with all related state, community behavioral health, and contracting organizations.
• Identify potential opportunities for new business development.
• Assist in grant preparation through direct writing and through work with the managers in the design of new programs.
• Assist the managers/clinical coordinators with the provision of program details and information to assist in the budget process.
• Assist in the preparation of departmental budget and demonstrate a functional responsibility for administering and managing the approved departmental budget.
• Instruct and train volunteers, interns, contract staff and regular staff in their respective disciplines as assigned.
• Negotiate contracts with providers of clinical, prevention and training services, including psychiatrists, psychologists, therapists, trainers, other programs, and specialty services.
• Participate in agency fund raising activities as requested by management.
• Work as part of the agency executive team to further the organizational mission and goals.
• Attend management and administrative meetings.

• Leverage your background in Pain Medicine disciplines to deliver evidence-based medical reviews that support high-quality patient care.
• Collaborate with healthcare providers and stay current on healthcare regulations and industry developments as you review a wide range of cases.
• Start training remotely in a structured environment with support from trainers, mentors, and leadership to set you up for success.
• Complete time-sensitive, specialized evidence-based medical case reviews for medical necessity on EviCore’s case management software.
• Conduct physician consultation (peer-to-peer) calls with referring providers to discuss evidence–based medical necessity and appropriateness of the requested service or treatment.
• Leverage your clinical expertise to recommend alternative services or treatments as necessary.
• Work collaboratively with over 500 EviCore physician colleagues to help ensure patients receive proper care via evidence-based decision making.

Medical Director – Pain Medicine

• Design, implement, and improve education, quality, and accreditation programs
• Develop and manage training curriculum for clinical staff
• Design and deliver palliative care-specific education programs
• Integrate value-based care principles into training frameworks
• Oversee simulation-based training and competency assessments
• Lead the organization's QA/QI program and establish quality metrics
• Analyze clinical and operational data for improvement
• Collaborate with the Compliance Department for regulatory education

Clinical Director – Training & Quality

• Develop and manage the Clinical Policy, Regulatory, and Compliance functions within the Office of Clinical Affairs.
• Ensure clinical operations meet healthcare laws and standards.
• Develop and maintain regulatory policies.
• Manage compliance risks and guide policy-related submissions.
• Advise senior leadership and work closely with teams across the organization.

Medical Director, Clinical Regulatory Affairs

• You’ll start training remotely in a structured environment with support from trainers, mentors, and leadership to set you up for success.
• Complete time-sensitive, specialized evidence-based medical case reviews for medical necessity on EviCore’s case management software.
• Conduct physician consultation (peer-to-peer) calls with referring providers to discuss evidence–based medical necessity and appropriateness of the requested service or treatment.
• Leverage your clinical expertise to recommend alternative services or treatments as necessary.
• Work collaboratively with over 500 EviCore physician colleagues to help ensure patients receive proper care via evidence-based decision making.

Medical Director – Medical Genetics, Genomics

• Determine the medical appropriateness of inpatient, outpatient, and pharmacy services by reviewing clinical information and applying evidence-based guidelines.
• Influence departmental strategy, leading and overseeing a team of physicians ensuring efficient management and adherence to quality standards.
• Report into the Senior Medical Director.
• Provide timely medical reviews that meet Oscar's stringent quality parameters.
• Provide clinical determinations based on evidence-based criteria and Oscar internal guidelines and policies, while utilizing clinical acumen.
• Clearly and accurately document all communication and decision-making in Oscar workflow tools.
• Use correct templates for documenting decisions during case review.
• Conduct timely peer-to-peer discussions with treating providers to clarify clinical information and to explain review outcome decisions.
• Manage direct reports and oversee their performance.
• Provide oversight to ensure the team meets turn-around times for clinical reviews.
• Collaborate with other departments on Utilization Management Operations.
• Lead key projects and drive initiatives to successful completion.

Associate Medical Director, Utilization Management

• Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit
• Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities
• Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services
• Supports effective implementation of performance improvement initiatives for capitated providers
• Assists Chief Medical Director in planning and establishing goals and policies to improve quality and cost-effectiveness of care and service for members
• Provides medical expertise in the operation of approved quality improvement and utilization management programs
• Assists the Chief Medical Director in the functioning of the physician committees
• Conduct regular rounds to assess and coordinate care for high-risk patients
• Collaborates effectively with clinical teams, network providers, appeals team, medical and pharmacy consultants for reviewing complex cases and medical necessity appeals
• Participates in provider network development and new market expansion as appropriate
• Assists in the development and implementation of physician education with respect to clinical issues and policies
• Identifies utilization review studies and evaluates adverse trends in utilization of medical services
• Identifies clinical quality improvement studies to assist in reducing unwarranted variation in clinical practice
• Interfaces with physicians and other providers in order to facilitate implementation of recommendations to providers
• Reviews claims involving complex, controversial, or unusual or new services in order to determine medical necessity and appropriate payment
• Develops alliances with the provider community through the development and implementation of the medical management programs
• May represent the business unit before various publics both locally and nationally on medical philosophy, policies, and related issues
• May be required to work weekends and holidays in support of business operations, as needed

Medical Director, Appeals

• Provide comprehensive behavioral health care management to facilitate delivery of appropriate quality care and improve program/operational efficiency involving clinical issues
• Provide leadership and day-to-day physician oversight for utilization management team, including the management of high-risk cases and medical necessity decisions
• Participate in the development, implementation, and evaluation of clinical/medical programs
• Provide psychiatric leadership to an interdisciplinary utilization management team, including medical/clinical oversight, consultation and training
• Assist with the development, implementation, monitoring and evaluation of the utilization management program and action plan, ensuring quality and appropriateness of care
• Provide psychiatric leadership for NCQA-compliant clinical quality improvement activities in collaboration with clinical and quality improvement staff

Medical Director – Behavioral Health

• Oversee and manage day-to-day operations of a healthcare facility or clinical department
• Provide direct clinical support, evaluate and treat complex patient cases
• Supervise and mentor clinical staff, conduct performance reviews
• Manage clinic budgets, resources, and daily operations, including payroll
• Ensure adherence to healthcare laws, regulations, and ethical standards
• Act as a liaison between staff, patients, families, and administration
• Assess urgent health needs of patients, analyze data, and formulate care plans
• Maintain integrity and security of privacy laws
• Respond to inquiries using knowledge of established policies and procedures
• Maintain professionalism, ethical standards and confidentiality of company information

Clinical Director

• Provides executive clinical leadership for the provision and delivery of healthcare services in a high-security facilities with diverse and high-risk populations, ensuring quality, patient safety, and regulatory compliance.
• Oversee ambulatory care, inpatient/observation beds, behavioral health, dental, pharmacy, ancillary services, and specialty care referrals.
• Develop plans, policies, and standard operating procedures based on best practices and government requirements.
• Lead credentialing/privileging, peer review, and clinical governance.
• Chair Quality Management/CQI committees; monitor KPIs and sentinel events.
• Ensure emergency response readiness (code blue, mass casualty) and chronic disease management programs.
• Coordinate with facility operations on population health risks and special needs.
• Participate in drills and emergency responses as assigned.

Director of Medical Services

• The Director of Clinical Services (DCS) is accountable for clinical and operational excellence within a defined book of business in an Envision Physician Services operating unit.
• This position drives improvements in patient care processes and outcomes by partnering with local practice medical leadership and front-line clinicians.
• Within a defined book of business, the DCS balances the needs and opportunities of a client with internal EMG relationships throughout their portfolio.
• The DCS identifies areas of opportunity within their book of business and works collaboratively with operating unit leadership team to provide partnership to medical directors and clients towards performance enhancement and goal achievement.
• The DCS drives implementation of clinical quality, service line clinical operations, corporate initiatives.
• In addition, the DCS leverages their client relationships to influence and ultimately improve clinician engagement, customer value and contract retention by partnering with Envision business owners.
• They will evaluate and identify areas of opportunity for improvement with our health system and hospital.
• Participates and supports initiatives dedicated to delivery of safe, high quality, patient centered care.

Director of Clinical Services – Value and Innovation

• Provide therapeutic area/product expertise for designated therapeutic area in assigned territory
• Plan and execute Medical strategy and engagement for assigned customers
• Maintain required knowledge of relevant TA and Pfizer medicines
• Serve as a conduit for Medical Information and customer insights
• Understand Pfizer Medical Affairs priorities for content strategy development
• Maintain effective communication with headquarters Medical colleagues
• Optimize patient-centricity of Medical communications and deliverables
• Deliver approved medical content about Pfizer medicines
• Identify and seek medical engagement from priority customer segments
• Lead advisory boards and field queries from HCPs
• Collaborate with Global Medical Affairs and partner with Oncology Research & Development

Oncology Field Medical Director, GU – Prostate Cancer

• Partner with the Market General Manager and oversee all medical operations
• Provide medical leadership for various programs including diagnosis and documentation
• Engage with medical group leaders to implement value-based care
• Lead the Director of Nursing & Clinical Operations and/or Market Clinical Director
• Handle clinical issues and escalate patient complaints
• Develop relationships with external partner practices

See all jobs on JobTailor

Group Medical Director

Medical Director

Medical Director

Medical Director – Pain Medicine

Clinical Director – Training & Quality

Medical Director, Clinical Regulatory Affairs

Medical Director – Medical Genetics, Genomics

Associate Medical Director, Utilization Management

Medical Director, Appeals

Medical Director – Behavioral Health

Clinical Director

Director of Medical Services

Director of Clinical Services – Value and Innovation

Oncology Field Medical Director, GU – Prostate Cancer

Chief Medical Officer