Medical Director

• Own end‑to‑end accountability for the EDC platform across strategy, delivery, operations, and value realization
• Define and govern multi‑year product vision and roadmap, aligned with Pfizer clinical and digital strategies
• Facilitate and drive final prioritization and trade‑off decisions across scope, funding, risk, and timeline
• Ensure compliance, data integrity, and audit readiness in partnership with Regulatory, Quality, and IT stakeholders
• Responsible for decisions that impact the overall product vision and metrics (e.g., Objectives & Key Results (OKRs) fulfillment
• Create, maintain, and execute against a prioritized roadmap for the Clinical business
• Establish strong relationships with key business stakeholders and serve as a strategic partner in product decision making
• Work with cross-functional teams of architects, engineers, and designers to deliver customer-centric product features
• Apply user-centered design principles and practices in the product development lifecycle
• Exercise strong decision-making mandate across cross-functional teams
• Stay in sync with the Product Owners on priorities and day-to-day decision making
• Prepare and support the agile team on product demos
• Contribute to the overall success and lifecycle of the product during definition, design, user story/requirement creation, documentation, launch, management updates, and metrics
• Oversee creation of user stories/specs and data analysis to justify product decisions and apply key learnings
• Create and deliver presentations to stakeholders and users
• Responsible for managing and/or retiring other CDMS systems (i.e. RAVE, Inform, DMW, OC)

Director, Clinical Technology, EDC Product Manager

• Provide clinical leadership and expertise to Medical Management staff, ensuring timely, consistent, and evidence-based responses to members and providers.
• Lead utilization management and quality assurance activities, including oversight of medical necessity reviews and case management initiatives.
• Support medical management programs through active participation in interdisciplinary clinical team activities and strategic decision-making.
• Serve as the primary clinical and business liaison to network providers and healthcare facilities, fostering collaboration and supporting the effective implementation of medical services programs.
• Conduct predetermination reviews and claim determination reviews, applying clinical judgment and expertise in medical coding, reimbursement, and coverage policies.
• Provide guidance and consultation on complex clinical cases, helping ensure quality outcomes and regulatory compliance.
• Support the development and continuous improvement of medical management strategies, policies, and processes.

Medical Director – Pain Management

• Translate enterprise clinical global talent strategy into execution through structured, wave-based implementation plans that deliver measurable value across cost, quality, and scalability
• Partner across Clinical, Enterprise Strategy, Global Talent, and external vendors to define and evolve the global clinical operating model, including scope such as utilization management, case management, pharmacy support, and administrative services
• Lead clinical role assessment and governance processes to determine optimal role location, ensuring alignment with licensure requirements, regulatory standards, accreditation needs, and client contract obligations
• Establish clear guardrails and scope boundaries by identifying which clinical roles are appropriate for globalization and documenting rationale to support decision-making and compliance reviews
• Design and lead clinical transition planning, including vendor engagement, operating model selection (BPO, captive, or hybrid), and readiness assessments to support safe, compliant implementation
• Ensure transition designs account for clinical-specific requirements such as credentialing, licensure, supervision structures, and enhanced quality and audit checkpoints
• Build and scale global clinical and non-clinical teams by partnering with Talent Acquisition and HR to deliver recruiting, credentialing, and onboarding pipelines aligned to market supply and regulatory expectations
• Establish clinical leadership models, including supervision layers and on-site leadership roles, to support safe delivery and clinical governance at scale
• Implement end-to-end clinical process ownership with embedded quality metrics, productivity measures, service-level agreements, and patient safety indicators to ensure consistent outcomes
• Ensure readiness for audits, accreditation, and client assurance processes, including data privacy, regulatory adherence, and quality performance standards
• Design governance structures and value tracking methodologies that measure role transitions, cost-to-serve improvements, time-to-proficiency, and clinical quality outcomes
• Proactively identify and escalate risks related to regulatory compliance, workforce readiness, and clinical quality, enabling timely resolution and continuous improvement
• Drive stakeholder alignment and change management across clinical leaders, business units, Legal, Compliance, and Enterprise stakeholders to support successful global hub implementation
• Develop and deliver executive-level communications and presentations that clearly articulate strategy, progress, and value realization of the clinical global talent model

Global Clinical Program Strategy Director

• Shape clinical pharmacology strategy across drug development programs
• Apply PK/PD, pharmacometrics, and model-informed drug development approaches
• Collaborate across clinical, regulatory, biostatistics, translational, and CMC teams
• Lead high-impact work and contribute to programs that shape the future of HIV treatment and prevention

Director, Clinical Pharmacology

• Oversee the performance and growth of Customer Service, Prescription Processing, Client-specific teams, managing both internal staff and external vendors
• Lead operational excellence across central fill pharmacy networks and courier delivery operations
• Lead your team with Key Performance Indicators (KPIs) to drive business success and increase efficiency while lowering the cost-to-fill on an annual basis
• Manage quality, turnaround time (TAT), and customer satisfaction metrics to ensure FuzeRx remains the preferred infrastructure partner for telehealth and pharma partners
• Establish requirements for capabilities and reporting, collaborating cross-functionally to deliver data-driven insights
• Analyze data to forecast staffing needs based on program performance, optimizing resource allocation across multiple roles
• Lead a large team of managers, supervisors and team members, establishing an environment of positive employee engagement and experience

Director, Rx Clinical Operations

• Define and execute Medicaid risk adjustment strategy across markets and plans
• Lead and deliver high-impact strategic initiatives that improve revenue accuracy, compliance, and overall performance
• Align risk adjustment programs with state Medicaid models (e.g., CDPS, CRG, or state-specific methodologies)
• Represent risk adjustment Medicaid informatics in executive forums
• Oversee health plan performance using advanced analytics and use proactive data insights to drive strategies and evidence-based decision-making
• Lead development of scalable data pipelines and reporting frameworks using claims, encounters, pharmacy, and clinical data
• Ensure accuracy, integrity and completeness of Medicaid encounter submissions and data
• Establish and oversee processes to ensure accuracy, completeness, and integrity of risk capture
• Direct suspecting logic development, gap identification, and prioritization strategies for operational programs and interventions
• Lead and develop a high-performing, multidisciplinary team spanning informatics, risk analytics, reporting, and operational program support

Lead Director, Healthcare Medicaid Risk Adjustment Analytics

• Provides enterprise leadership for U.S. Employer Medical Customer Service organization
• Oversees the strategic direction, operational performance, and transformation agenda across all medical service lines
• Partners extensively with enterprise leaders to define and execute strategies that improve customer experience, enhance efficiency, optimize service delivery, and accelerate business performance
• Establishes multi-year operational strategies, leads complex transformation initiatives, drives adoption of emerging technologies and AI-enabled capabilities
• Champions talent development, organizational effectiveness, and change leadership while fostering a high-performance culture

Senior Director – US Employer Operations, Head of Medical Call Centers

• Work within the Medical Affairs organization to identify, establish, and manage collaborative professional relationships with community-based scientific leaders (SLs) and healthcare providers.
• Conduct peer-level scientific discussions and maintain a reliable presence to ensure SLs have a Medical Affairs contact within our company.
• Engage in proactive non-product discussions regarding scientific issues to understand real-world prevention gaps, persistent disparities, and barriers to uptake across various care settings.
• Facilitate appropriate scientific exchange of information with SLs, including integration of scientific knowledge with actionable insights to inform our Company's research, development and strategies.
• Communicate external stakeholder opinions, insights, and feedback on new data, clinical trends, and the evolving HIV treatment and prevention landscape to Medical Affairs HQ teams.
• Represent R&D at scientific meetings and congresses to understand the sentiment of the consumer and contribute to R&D debriefs, insight discussions, and post-congress reports.
• Develop and execute territory plans in alignment with global Virology strategy.
• Support data generation activities when requested by R&D leadership, including our company's Investigator Study Program (MISP).
• Identify potential investigators for participation in phase II-IV clinical development programs and provide scientific support for R&D sponsored trials as needed.
• Demonstrate and maintain in-depth knowledge of the assigned disease and therapeutic area(s) through educational efforts.
• Fully comply with all company policies and applicable laws, regulations, and ethical standards.

Virology Community MSL, Regional Medical Scientific Associate Director

• Support Medical Management staff ensuring timely and consistent responses to members and providers.
• Lead all aspects of utilization review/quality assurance, directing case management.
• Provide clinical expertise and business direction in support of medical management programs through participation in clinical team activities.
• Act as lead business and clinical liaison to network providers and facilities to support the effective execution of medical services programs by the clinical teams.
• Responsible for predetermination reviews and reviews of claim determinations, providing clinical, coding, and reimbursement expertise.

Medical Director – Ortho/Total Joint

• Analyze access/reimbursement issues and opportunities
• Provide strategic accounts product access/reimbursement expertise
• Provide access/reimbursement education to field teams and matrix partners
• Coordinate on access/reimbursement issues with third parties including hubs
• Support patient access to the products by providing subject matter expertise on reimbursement issues that may be barriers to product access

Associate Director, Field Reimbursement, Corporate Account

• Operate as the subject-matter expert on reimbursement, access, and coverage issues affecting ViiVs long acting injectables
• Prioritize Key National Strategic Accounts/IDNs, ensuring their implementation needs for ViiV Long Acting Injectables are realized
• Build a stronger implementation presence in key accounts
• Develop and orchestrate a top-down integrated implementation approach aligned to the account’s implementation needs
• Effectively navigate complex situations with internal and external customers that require sound judgment, problem solving skills, and awareness of rules and regulations

• Manage a professional clinical team responsible for consulting with internal partners, clients, and brokers to identify opportunities where Sun Life Health Care Capabilities can support members, improve access to care, and help clients achieve better financial and health outcomes.
• Lead the team in identifying members and client populations that may benefit from Sun Life Health Care Capabilities, including Clinical 360, Clinical 360+, care navigation, specialty care support, and other solutions that optimize health and reduce avoidable costs.
• Monitor Quality Assurance (QA) reviews regularly and provides staff coaching related to quality measures and feedback.
• Sets performance goals to drive individual performance; reviews staff through the use of performance review tools and provides regular coaching and performance, growth and developmental feedback.
• Provides career development and training opportunities.
• Makes decisions on personnel actions such as hiring, terminations, promotions, salary increases.
• Supports individuals in the identification and implementation of innovative solutions or efficiencies.
• Creates collaborative relationships across Distribution, Client Services, Product, Claims, Operations, vendor partners, and other Health and Risk Solutions teams to support a coordinated service model for clients and brokers.
• Serves as a leading contributor to special projects, operational readiness, and change management activities that advance Sun Life’s health capabilities strategy, improve broker and client engagement, and support measurable outcomes.
• Understands client, broker, member, and business needs and fosters an interdisciplinary clinical operating model that connects clinical expertise, relationship management, and health capability execution.
• Develops and reinforces servicing approaches that clarify roles, improve response consistency, and strengthen broker and client confidence in Sun Life’s ability to deliver health-focused value.
• Maintains operating expenses within budget.
• Ensures Key Performance Indicators are met.
• Other duties as assigned.

Associate Director, Clinical Services

• Lead, develop, direct, and implement clinical and non-clinical activities that impact health care quality, cost, and outcomes.
• Direct the utilization review process and oversee the quality of utilization determinations, including case reviews, peer to peer provider discussions, and appeals.
• Ensure compliance with clinical goals through monitoring of care management performance.
• Oversee application of medical policies to ensure the appropriate and most cost-effective medical care is received, and for the day-to-day management of medical management staff.
• Recommend changes and enhancements to current managed care, review guidelines, and clinical criteria based on extensive knowledge of health care delivery systems, utilization methods, reimbursement methods, and treatment protocols.
• Develop, implement, and interpret medical policy including medical necessity criteria, clinical practice guidelines, and new technology assessments.
• Lead clinical staff in the coordination of quality care.
• Provide clinical expertise and business direction in support of medical management programs through participation in clinical team activities.
• Analyze policy/procedure/workflows on case management and utilization management for redesign and efficiency opportunities.
• Act as lead clinical liaison to select plan sponsors including reviewing clinical trends, exploring new clinical strategies, handling escalations, and supporting sales and renewal activities as needed.
• Support and train SMDs and MDs on such activities.
• Identify and advance new affordability initiatives for the Commercial line of business, not limited to medical policy and utilization review activities.
• Monitor KPIs and trends to understand value and opportunities and expand Aetna's medical management programs to address member needs across the continuum of care.
• Provide clinical support for UM/CM/Appeals complex or escalated cases as appropriate.
• Participate in an on‑call rotation, including occasional weekend coverage.

Executive Medical Director, Commercial

• Provides leadership of medical management activities in Aetna’s Northeast region (Maryland, New Jersey, New York, Pennsylvania, and Virginia)
• Lead a team of Medical Directors
• Collaborate with health plan chief medical officers
• Implement medical management programs/policies
• Direct the utilization review process and oversee the quality of utilization determinations

Senior Medical Director – Medicaid

• Define and execute the development strategy of oncology program(s)
• Lead one or more subteams in clinical development
• Serve as the clinical lead across multiple clinical trials
• Provide oversight and management responsibilities of medical directors
• Accountable for clinical development strategy, trial design, execution, and results delivery
• Oversee the development and management of clinical protocols and amendments
• Lead peer-to-peer interactions with investigators
• Collaborate with Clinical Scientist to review and interpret clinical data.

Clinical Development Executive, Medical Director – GI Oncology

• Drive Quality Medicine & Patient Safety
• Ensure consistent delivery of high-quality, evidence-based care across hospitals
• Coach and develop Medical Directors through record reviews, hospital visits, and real-time feedback
• Champion patient safety initiatives, including event reporting and continuous improvement efforts
• Support adoption of new medical advancements, standards of care, and clinical best practices
• Partner with teams to improve client communication, case management, and follow-up care
• Oversee medical record quality, equipment standards, and clinical compliance
• Manage medical-related client concerns and board complaints through resolution
• Foster a culture of collaboration, accountability, and psychological safety
• Partner with Field Leadership, Medical Affairs, and operations to align priorities and execution
• Support recruiting, hiring, and onboarding of veterinarians, including new graduates
• Proactively identify and address medical, staffing, and operational challenges
• Serve as the medical voice within the field leadership team
• Mentor and grow Medical Directors and veterinarians through coaching and development planning
• Support onboarding, training, and integration of new doctors
• Guide teams on improving efficiency, productivity, and team-based care delivery
• Create an environment that supports continuous learning and career growth

Group Medical Director – Specialty

• Provide strategic leadership and clinical oversight for DSNP/FIDE complex populations.
• Lead a team of Senior Medical Directors/Medical Directors within the Center of Excellence (COE) Duals.
• Drive medical management programs and policies that improve quality, cost, and outcomes across the continuum of care.
• Ensure compliance, operational excellence, and superior member experience.
• Actively participate in scheduled team and leadership meetings supporting the EMD.

Lead Senior Medical Director, DSNP

• Responsible for medical and scientific oversight of clinical trials in Internal Medicine
• Provides timely, study-related medical information and guidance
• Conducts and documents periodic safety data review and ongoing clinical/medical data review
• Represents the study team in internal protocol review governance submissions and interactions
• Develops site selection criteria and ensures protocol training is delivered to site-facing colleagues
• Ensures TMF compliance for clinical documents
• Develops clinical guidance and reviews safety data

Clinical Development Medical Director, MD Required

• Serve as Clinical Trial Director for Phase 1–4 trials, designing study protocols and supplementary documentation, including study procedures manuals, analysis plans, and protocol deviation plans.
• Provide medical governance, ensuring clinical and operational excellence in study execution.
• Manage study conduct, enrollment strategies, and interpretation of clinical data.
• Provide expertise in managing safety events and toxicity concerns.
• Train internal and external teams on protocol-defined safety parameters.
• Ensure comprehensive documentation of trial-related inquiries and safety events in the electronic Trial Master File.
• Partner with internal teams in virology, pharmacology, biostatistics, drug safety, regulatory affairs, and discovery science to design efficient clinical studies.
• Collaborate with external investigators, consultants, institutional review boards (IRBs)/research ethics committees (RECs), and community stakeholders for trial feasibility, conduct, and reporting.
• Assist in developing submissions for regulatory bodies (U.S. and international) during and post-study phases.
• Prepare responses to regulatory queries and present clinical trial findings to internal governance groups.
• Foster strong professional relationships and teamwork within a matrix environment to drive project success.
• Thrive in a fast-paced, dynamic setting while demonstrating leadership and adaptability.
• Contribute to organizational growth and innovation, supporting the mission of global impact.

Medical Director jobs in Connecticut

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Director, Clinical Technology, EDC Product Manager

Medical Director – Pain Management

Global Clinical Program Strategy Director

Director, Clinical Pharmacology

Director, Rx Clinical Operations

Lead Director, Healthcare Medicaid Risk Adjustment Analytics

Senior Director – US Employer Operations, Head of Medical Call Centers

Virology Community MSL, Regional Medical Scientific Associate Director

Medical Director – Ortho/Total Joint

Associate Director, Field Reimbursement, Corporate Account

Associate Director, Field Reimbursement, Corporate Account

Associate Director, Clinical Services

Executive Medical Director, Commercial

Senior Medical Director – Medicaid

Clinical Development Executive, Medical Director – GI Oncology

Group Medical Director – Specialty

Lead Senior Medical Director, DSNP

Clinical Development Medical Director, MD Required

Medical Director, R&D Physician Center of Excellence