Medical Director

• Responsible for the appeal reviews for physical health medical services
• Ensure the appropriate and most cost-effective medical care is received
• Develop and implement programs to improve quality, cost, and outcomes
• Provide clinical consultation and serve as clinical/strategic advisor to enhance clinical operations
• Identify cost of care opportunities
• Supports clinicians to ensure timely and consistent responses to members and providers
• Provides guidance for clinical operational aspects of a program
• Conduct peer-to-peer clinical case reviews with attending physicians or other ordering providers
• Serves as a resource and consultant to other areas of the company
• May represent the company to external entities and/or serve on internal and/or external committees
• May chair company committees
• Interprets medical policies and clinical guidelines
• May develop and propose new medical policies based on changes in healthcare
• Leads, develops, directs, and implements clinical and non-clinical activities that impact health care quality cost and outcomes
• Identifies and develops opportunities for innovation to increase effectiveness and quality

Medical Director – Medicare

• Lead the North American (U.S. and Canada) Medical Affairs strategy across all therapeutic areas and product classes, including medical vision, strategic objectives, evidence-generation portfolio, key opinion leader engagement, and resource plan
• Support the positioning of Medical Affairs as a strategic pillar on par with R&D and Commercial in shaping product strategy and the external scientific narrative
• Set Medical Affairs priorities based on scientific need and stakeholder impact
• Own the North American (U.S. and Canada) Medical Affairs workforce strategy across Hikma FTEs and contracted agency personnel, including MSLs, medical writers, and medical information specialists
• Manage build-vs-partner decisions, including current in-house MSL coverage and upcoming launch-program MSL build
• Own and oversee onboarding, certification, and annual recertification for all Medical Affairs personnel (FTEs and contractors).
• Establish and maintain strong relationships with key opinion leaders, healthcare professionals, and other relevant stakeholders in the U.S. and Canadian markets
• Own publication strategy, scientific platforms, congress strategy, and authorship governance across the portfolio

Director – North America Medical Affairs

• Serve as a senior clinical leader and addiction medicine subject matter expert across the organization.
• Partner with Clinical Services leadership to strengthen clinical quality, consistency, and patient safety across Boulder’s care delivery model.
• Lead routine review and refinement of clinical protocols, formulary standards, and evidence-based practice guidelines.
• Support quality assurance activities, chart review processes, and clinical audits to identify opportunities for improvement.
• Provide consultation and guidance on complex clinical cases and emerging clinical issues.
• Ensure Boulder’s clinical standards remain aligned with current evidence, regulatory requirements, and payer expectations.
• Partner with Clinical Services leadership to strengthen clinical leadership capabilities across the organization.
• Provide mentorship, coaching, and support to clinical leaders and clinicians navigating complex clinical and operational challenges.
• Help establish and reinforce standards of clinical excellence, professional growth, and evidence-based practice.
• Contribute physician leadership and oversight to clinician education, onboarding standards, and ongoing clinical development programs.
• Support the development of systems that promote accountability, consistency, and continuous improvement across the clinical organization.
• Translate quality findings, operational priorities, and emerging evidence into scalable clinical workflows and care delivery standards.
• Identify gaps in clinical processes, policies, and infrastructure and partner across teams to implement solutions.
• Support implementation of new clinical initiatives and ensure clinical best practices are operationally viable and consistently applied.
• Drive adoption of new clinical workflows, protocols, and care models across a distributed clinical workforce.
• Partner with Medical Affairs and Clinical Services leadership to evaluate and support expansion into new service lines and care models.
• Assess clinical readiness, staffing considerations, protocol requirements, and quality implications for new programs.
• Ensure new services are designed with appropriate clinical governance, quality standards, and outcome measurement strategies.
• Contribute clinical expertise to Boulder’s long-term vision of comprehensive substance use disorder care.
• Serve as a clinical liaison to Product, Operations, Analytics, and other cross-functional teams.
• Translate clinical priorities into product requirements, workflows, and operational processes.
• Provide clinical input on care delivery technology, clinical decision support tools, AI-enabled workflows, and platform enhancements.
• Ensure operational and product changes are evaluated through the lens of patient safety, clinician experience, clinical effectiveness, and quality.

Medical Director – Addiction Medicine, Telehealth

• 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

• responsible for the development and ongoing management of clinical research programs
• assists with project budgets and forecasting
• manages external client-facing relationships
• leads strategic initiatives focused on process improvement and operational effectiveness

Clinical Research Program Director

• Oversee the hiring process for all therapists at their clinic
• Provide all training for clinic new hires
• Assess ongoing development and training needs
• Hold staff compassionately accountable to meeting performance expectations
• Manage staff performance, including implement Performance Coaching and Performance Improvement Plans
• Provide training, staff development, and administrative oversight to support the functioning of the clinic
• Collaborate with franchise owner and Ellie Mental Health corporate staff to implement strategies for fiscal and clinical efficiency
• Spearhead clinic’s community outreach and engagement efforts
• Collaborate with Ellie Corporate Marketing Team to promote clinic’s online visibility
• Diagnose, create and maintain individualized treatment plans and maintain ongoing clinical documentation in EHR system

Clinical Director – Licensed Psychologist

• Share vision for improving and expanding access to quality mental health care
• Oversee overall clinical performance and operations of the clinic
• Sign and provide feedback on dependent licensed staff and interns notes
• Manage staff performance and hire clinical staff
• Provide new hire training
• Accountable to meeting clinic’s fiscal goals
• Develop and sustain relationships with referral partners
• Provide ongoing administrative and clinical oversight
• Maintain a small caseload of 10-15 clients weekly
• Collaborate with Franchise Owner and other Clinical Directors

Clinical Director – OH Licensed Psychologist

• Be the Voice of Clinical Trust Represent Elsevier as a senior clinical authority in high-impact customer engagements, partnerships, global forums and digital marketing.
• Build enduring relationships with healthcare leaders, academic institutions, and professional societies.
• Serve as a thought leader in clinical AI, evidence-based practice, and digital health transformation.
• Ensure that products are optimized to deliver utmost clinical value to users by evangelizing clinician needs.
• Define Clinical Value at Scale Establish what “great” looks like for clinical value across our solutions—from decision support to Competency Management.
• Define a holistic content strategy to evolve current products from providing reference information to providing advanced clinical decision support.
• Assess content data strategy and utilization to inform overarching roadmaps.
• Ensure our products deliver measurable, real-world impact for clinicians and patients.
• Create consistent standards for evidence, transparency, and trust across the portfolio.
• Own how critical clinical decisions are made, escalated, and resolved across the business.
• Act as the ultimate arbiter to ensure clinical efficacy and quality aligns with technical or commercial priorities.
• Partner with product and data science teams to ensure innovation is grounded in clinical best practice and overall efficacy.
• Help shape industry standards for responsible, evidence-based AI.
• Ensure a consistent and trusted clinical voice across the entire clinician journey.

Global Chief Medical Officer

• Supports clinicians to ensure timely and consistent responses to members and providers
• Provides guidance for clinical operational aspects of a program
• Conducts peer-to-peer clinical reviews with attending physicians or other providers to discuss review determinations
• Serves as a resource and consultant for other areas of the company
• May chair company committees
• Interprets medical policies and clinical guidelines
• Identifies and develops opportunities for innovation to increase effectiveness and quality

Medical Director – Physical Medicine and Rehabilitation

• Provides medical oversight of assigned clinical studies in the duty as a medical monitor
• Often serves as primary medical contact for customers for assigned clinical studies
• Provides medical input and oversight in support of the Drug Safety and Pharmacovigilance department
• Responsible for protocol design and development, upon request
• Provides input into protocol amendments
• Develops and delivers project-specific and therapeutic training to project team members and clinical site staff; provides training to customer staff as needed
• Provides medical and therapeutic input to Study Start Up, Feasibility, and Subject Identification efforts
• Provides medical input into data collection tools, monitoring plans, and review and analysis plans
• Provides oversight to assigned Medical Scientist staff and Medical Director colleagues to review clinical data
• Presents identified trends and issues, and mitigation strategies, to customers and project team members to minimize risks to subject safety or integrity of study data
• Provides after-hours medical coverage for clinical studies
• Adheres to all enterprise policies, work instructions, standard operating procedures, and project plans
• Adheres to customer policies and standard operating procedures, as required in project plans
• Maintains in-depth knowledge of FDA and worldwide drug development regulations and national and ICH Good Clinical Practice (GCP) guidelines
• May support responses to Requests for Proposals (RFPs) or Bid Defense Meetings (BDMs), upon request
• May provide input to clinical development or regulatory teams within the Company, upon request
• May represent the Company at scientific meetings, upon request

Medical Director – HIV Research, Clinical/Observational Research

• Use your medical background, experience, and judgement to make determinations whether requested services, requested level of care, or requested site of service should be authorized, with all work occurring within a context of regulatory compliance and assisted by diverse resources
• Learn Medicaid requirements and understand how to operationalize this knowledge in your daily work assigned cluster
• Work includes computer-based review of moderately complex to complex clinical scenarios, review of all submitted clinical records, prioritization of daily work, communication of decisions to internal associates, and possible participation in care management
• Conducts discussions with external physicians by phone to gather additional clinical information or discuss determinations through the peer-to-peer process
• May speak with contracted external physicians, physician groups, facilities, or community groups to support regional market priorities
• Supports Humana values including working collaboratively on a team throughout all activities
• Flows to work as needed within cluster as needed for vacations, weekends and holidays coverage.

Behavioral Health Medical Director, Medicaid

• Oversees the administration of behavioral health services to ensure members receive appropriate, high-quality, and cost-effective care
• Provides clinical consultation and strategic guidance to strengthen clinical operations
• Supports the design and implementation of initiatives that improve quality, outcomes, and affordability
• Identifies and develops opportunities for innovation to increase effectiveness and quality
• Conducts peer-to-peer clinical reviews with attending physicians or other providers
• Serves as a resource and consultant to other areas of the company
• Attends Behavioral Health interdisciplinary team (IDT) meetings and other team-related meetings regularly

Behavioral Health Medical Director – Psychiatrist

• Reporting to the Department Administrator, assists with the global administration of the outpatient clinics through the management, coordination, and/or assessment of integrated clinic operations.
• Assesses and supports clinical efficiencies and enhancements, operational systems, contingency staffing, staff training, strategic operational performance, and patient experience.
• Participates in strategic and operational decision making as a member of the management team.
• Performs assessments of outpatient clinical operations and makes recommendations for operational enhancements and clinical efficiencies.
• Manages assigned clinical management and their teams; oversees the onboarding process for new managers in ambulatory clinics.
• Provides day to day operational management support in a clinic in the absence of a manager.
• Represents the LLC at various policy-making and/or operating committees.
• Assists in and provides input for determining strategic objectives, program and project development related to the outpatient clinics.
• Works in collaboration with Administrator and clinic management to develop, communicate and administer written policies, procedures, and protocols.

Director of Clinical Operations – Eye Physicians

• 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

• Responsible for appeal reviews for physical health medical services
• Ensure the appropriate and most cost-effective medical care is received
• Develop and implement programs to improve quality, cost, and outcomes
• Provide clinical consultation and serve as clinical/strategic advisor to enhance clinical operations
• Identify cost of care opportunities
• Supports clinicians to ensure timely and consistent responses to members and providers
• Provides guidance for clinical operational aspects of a program
• Conduct peer-to-peer clinical case reviews with attending physicians or other ordering providers
• Serve as a resource and consultant for other areas of the company

Medical Director – Oncology

• Responsible for the appeal reviews for physical health medical services
• Supports clinicians to ensure timely and consistent responses to members and providers
• Provides guidance for clinical operational aspects of a program
• Conducts peer-to-peer clinical case reviews with attending physicians
• Serves as a resource and consultant for other areas of the company
• May chair company committees
• Interprets medical policies and clinical guidelines
• Identifies and develops opportunities for innovation to increase effectiveness and quality

Medical Director jobs in Ohio

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