Medical Director

• 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

• Provide oversight and support for psychotherapy clinicians
• Engage through coaching and education of new and tenured clinicians
• Enhance ongoing clinician professional growth and development
• Work in a dyad partnership with the Practice Group Manager
• Implement clinical strategy and related operations

Clinical Director

• 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

Appeals Medical Director – Cardiology

• Plan and execute Medical strategy and engagement for appropriate assigned customers within a territory, compliantly coordinating with other Pfizer colleagues as needed to achieve Medical objectives
• Maintain required level of knowledge of relevant TA/disease states and Pfizer medicines, providing therapeutic area/product information to both internal and external stakeholders as needed
• Serve as a conduit and resource for Medical Information and customer insights, providing requested information to HCPs as allowed by Pfizer guidance and sharing customer viewpoints with Pfizer as appropriate
• Understand the priorities of Pfizer Medical Affairs in order to contribute to Medical content strategy development and execute aligned Field Medical tactics
• Maintain effective and appropriate communication and collaboration among headquarters Medical colleagues, Medical Information, and other Pfizer Field Medical colleagues
• Demonstrate expertise in communication across multiple channels, including, but not limited to, live and virtual presentations in small or large settings, written communication, and telephone or virtual conversations
• Optimize patient centricity of Medical communications and deliverables, incorporating Health Literacy and cultural awareness principles to ensure that patients remain the ultimate focus
• Deliver approved medical content about Pfizer medicines and relevant topics in the designated therapeutic area
• Identify and seek medical engagement from priority customer segments in assigned Therapeutic Area
• Provide truthful, accurate, and scientifically supported information in response to direct unsolicited medical requests from HCPs in a manner that complies with all applicable Pfizer guidelines, policies, and procedures
• Lead advisory boards (develop BRF, Agency collaboration) with manager oversight
• Field relevant inbound queries from HCPs via established triage process
• In collaboration with Global Medical Affairs colleagues, partner with Oncology Research & Development and Global Product Development (GPD) in the identification of potential sites for Pfizer-sponsored clinical trials
• Appropriately provide Medical support throughout the Investigator Sponsored Research (ISR) process
• Cultivate research and therapeutic area expertise, including familiarity with latest congress data and disease state literature
• Provide Asset leadership
• Understand the principles of study design, methodology, data analysis, and interpretation and communicate these concepts with customers
• Strong territory leadership
• Reactively and proactively communicate with local Patient Advocacy Group(s), as appropriate, in close collaboration with Corporate Affairs and HQ Medical Affairs
• Deliver insights on local patient organization structure, capabilities, and patient population needs
• Serve on Medical and/or TA and asset cross-functional committees, as appropriate
• Represent Pfizer Medical Affairs leadership with clinical/professional associations and/or societies, consistently demonstrating medical professionalism in all interactions
• Mentorship – Onboarding partner, ad board and study lead mentor
• Participate in special projects as needed

Field Medical Director – Oncology

• Responsible for appeal reviews for physical health medical services
• Ensure appropriate and cost-effective medical care is received
• May develop and implement programs to improve quality, cost, and outcomes
• Provide clinical consultation and serve as clinical/strategic advisor
• Identify cost of care opportunities
• Supports clinicians for timely and consistent responses to members and providers
• Provides guidance for clinical operational aspects of a program
• Conduct peer-to-peer clinical case reviews
• Serves as a resource and consultant for other areas of the company
• May represent the company to external entities and serve on committees
• Interprets medical policies and clinical guidelines
• May develop and propose new medical policies
• Leads, develops, directs, and implements clinical and non-clinical activities

Appeals Medical Director – Urology

• Assume the administrative authority, responsibility, and accountability of implementing medical services, policies, and procedures
• Coordinate medical care, including emergency treatment procedures
• Maintain effective liaison with attending physicians
• Implement methods to keep the quality of care under constant surveillance
• Provide necessary physician services for those residents within skilled nursing facilities and/or clinic environment

• Determines the medical necessity of requests using clinical criteria
• Performs physician-level case review of oncologic utilization requests
• Conducts peer-to-peer consultation with ordering physicians, physician assistants and advanced practice nurses regarding established guidelines and accepted standards of care as it relates to treatments, procedures, imaging and appropriate sites of service
• Provides education regarding applicable clinical criteria and discusses clinically appropriate options
• Performs first level provider appeals for coverage decisions
• Provides support and education to internal clinical and non-clinical staff regarding the principles associated with appropriate diagnoses, treatments, and management related to these specialties
• Participates in physician team meetings
• Participates in groups that develop, revise and enhance clinical appropriateness guidelines

Medical Director – Genetic Testing, Oncology

• Support BeOne Medicines pre-clinical and clinical pipeline development by coordinating external collaborations
• Establish and maintain scientifically credible peer-to-peer scientific relationships with national & regional opinion leaders
• Facilitate & monitor strategic partnerships with scientific/clinical experts
• Provide balanced, accurate information to regional formulary decision makers
• Identify and vet investigators, nominate sites to Clinical Operations for company-sponsored clinical trials
• Assist in the development and execution of clinically relevant regional medical meetings
• Serve as an internal resource of clinical and scientific information from medical interactions
• Build strong relationships with internal experts

Field Medical Director – Solid Tumor, Breast and Lung

• Provide clinical leadership across Morgantown and Williamson facilities
• Ensure all programming aligns with ASAM criteria, evidence-based practices, and trauma-informed care
• Lead treatment team processes and sign off on clinical reviews requiring licensed oversight
• Serve as the escalation point for complex clinical cases and crises
• Provide documented clinical supervision to licensed and license-eligible clinicians
• Conduct session observations and deliver structured, actionable feedback
• Manage direct reports including: PTO and scheduling oversight, performance evaluations and competency checklists, hiring, onboarding, and training
• Conduct routine chart audits, documentation reviews, and clinical service hour analysis
• Ensure timely and compliant completion of all clinical documentation
• Lead and support Acentra reviews and payer interactions
• Enhance and expand weekend programming and family programming and engagement
• Partner with Executive Directors and Operations to align staffing models and clinical outcomes

• Plan and execute medical strategy and engagement for assigned customers
• Maintain knowledge of relevant TA/disease states and Pfizer medicines
• Serve as a resource for medical information and customer insights
• Understand priorities of Pfizer Medical Affairs
• Maintain effective communication among medical colleagues
• Deliver approved medical content about Pfizer medicines
• Identify and seek medical engagement from priority customer segments
• Provide truthful, accurate, and scientifically supported information to HCPs
• Facilitate medical support throughout Investigator Sponsored Research (ISR) process
• Cultivate research and TA expertise
• Represent Pfizer Medical Affairs leadership

Oncology Field Medical Director – MD

• Ensure timely and consistent responses to members and providers related to precertification, concurrent review, and appeal request.
• Primarily responsible for Utilization Management, including prior authorization and precertification as well as concurrent review.
• Cases could focus on inpatient or outpatient, acute and post-acute as well as peer to peer calls and first level appeals.
• Participate in a rotating on call schedule to provide weekend and holiday coverage.

Medical Director – Medicaid

• Oversee the administration of behavioral health services
• Provide clinical consultation and strategic guidance
• Ensure timely and consistent responses to members and providers
• Conduct peer-to-peer clinical reviews
• Serve as a resource and consultant to other areas of the company

• Plan and execute medical strategy and engagement for appropriate assigned customers within a territory, compliantly coordinating with other Pfizer colleagues as needed to achieve medical objectives
• Maintain required level of knowledge of relevant TA/disease states and Pfizer medicines, providing therapeutic area/product information to both internal and external stakeholders as needed
• Serve as a conduit and resource for medical information and customer insights, providing requested information to HCPs as allowed by Pfizer guidance and sharing customer viewpoints with Pfizer as appropriate
• Understand the priorities of Pfizer Medical Affairs to contribute to medical content strategy development and execute aligned Field Medical tactics
• Maintain effective and appropriate communication and collaboration among headquarters medical colleagues and other Pfizer Field Medical colleagues
• Demonstrate expertise in communication across multiple channels, including, but not limited to, live and virtual presentations in small or large settings, written communication, and telephone or virtual conversations
• Optimize patient centricity of medical communications and deliverables, incorporating health literacy and cultural awareness principles to ensure that patients remain the ultimate focus
• Deliver approved medical content about Pfizer medicines and relevant topics in the designated therapeutic area
• Identify and seek medical engagement from priority customer segments in assigned TA
• Provide truthful, accurate, and scientifically supported information in response to direct unsolicited medical requests from HCPs in a manner that complies with all applicable Pfizer guidelines, policies, and procedures
• Field relevant inbound queries from HCPs via established triage process
• In collaboration with Global Medical Affairs colleagues, partner with Oncology Research & Development and Global Product Development (GPD) in the identification of potential sites for Pfizer-sponsored clinical trials, including identification of sites serving under-represented patient populations in trials
• Appropriately provide medical support throughout the Investigator Sponsored Research (ISR) process
• Cultivate research and TA expertise, including familiarity with latest congress data and disease state literature
• Provides asset leadership
• Understand the principles of study design, methodology, data analysis, and interpretation and communicate these concepts with customers
• Strong territory leadership
• Reactively and proactively communicate with local Patient Advocacy Group(s), as appropriate, in close collaboration with Corporate Affairs and HQ Medical Affairs
• Deliver insights on local patient organization structure, capabilities, and patient population needs
• Serve on Medical and/or TA and asset cross-functional committees, as appropriate
• Represent Pfizer Medical Affairs leadership with clinical/professional associations and/or societies, consistently demonstrating medical professionalism in all interactions
• Mentorship – Onboarding partner, ad board and study lead mentor
• Participate in special projects as needed

Oncology Field Medical Director – Non-MD

• Completing medical necessity reviews for substance use disorder cases
• Supporting clinicians for timely responses to members and providers
• Providing clinical operational guidance
• Conducting peer-to-peer clinical reviews

Medical Director – Addiction Medicine

• Manage BCBAs and RBTs to ensure clinical quality
• Supervise the daily implementation of behavior intervention, treatment plans, and client documentation
• Provide guidance to grow the clinical and professional skills of BCBAs
• Give direct verbal/written feedback to BCBAs and RBTs regarding clinical implementation, including modeling
• Conduct behavior and skill-based assessments and treatment plans for clients admitted into the region as needed
• Support BCBAs in extended assessment opportunities (FBA, FA, preference assessment, etc.)
• Meet weekly with BCBAs to review client progress
• Conduct on-site supervision of BCBAs and RBTs at service locations
• Make monthly check-in phone calls with families
• Support the ABA Academy of Excellence training program by analyzing regional IOA and treatment integrity data
• Develop (as a team) and oversee a clinic-based curriculum
• Collaborate with Regional Operations team
• Supervise unrestricted hours for BCBA Apprentices
• Travel for assessments, oversight of clinical team, and support for high-risk clients

See all jobs on JobTailor

Behavioral Health Medical Director – Psychiatrist

Clinical Director

Medical Director – Oncology

Appeals Medical Director – Cardiology

Field Medical Director – Oncology

Appeals Medical Director – Urology

Medical Director

Medical Director – Genetic Testing, Oncology

Field Medical Director – Solid Tumor, Breast and Lung

Clinical Director

Oncology Field Medical Director – MD

Medical Director – Medicaid

Behavioral Health Medical Director – Psychiatrist

Oncology Field Medical Director – Non-MD

Medical Director – Addiction Medicine

Clinical Director – BCBA