Medical Director

Based in Cerritos, CA, the Medical Director will oversee the administration of physical and/or behavioral health medical services, ensuring that patients receive appropriate and cost-effective medical care. This role includes developing and implementing programs to improve quality, cost, and clinical outcomes, providing strategic consultation, and identifying opportunities for innovation.

The Medical Director may also lead clinical programs, offer clinical guidance, and serve as a consultant and resource to both internal teams and external partners.

Compensation & Benefits: $263,488 - $395,232 plus excellent benefits package

Primary Responsibilities:

• Support clinicians to ensure timely and consistent responses to members and providers.
• Chart Review, Provide guidance on clinical operational aspects of programs.
• Conduct peer-to-peer clinical reviews with attending physicians or other providers regarding review determinations and patient visits.
• Represent the organization to external entities and serve on internal or external committees.
• Interpret and propose updates to medical policies and clinical guidelines based on healthcare changes.
• Lead, develop, and implement clinical and non-clinical initiatives that impact healthcare quality, cost, and outcomes.
• Identify and develop innovative opportunities to enhance effectiveness and quality.
• Full Time, Call 1:4

Requirements:

• MD or DO with Board certification approved by the American Board of Medical Specialties or American Osteopathic Association.
• Active, unrestricted medical license to practice medicine in the U.S.
• Minimum of 10 years of clinical experience.
• At least 5 years of experience providing healthcare, with additional experience as required by state contracts or regulations.
• Strong oral, written, and interpersonal communication skills, as well as problem-solving, facilitation, and analytical capabilities.

Additional Requirements:

• Must reside within a U.S. state or territory and not on a military base, vessel, or embassy for utilization review or appeals considerations.
• For URAC-accredited areas, professional competencies in communication, facilitation, and analytics are essential.

This position offers a competitive compensation range, opportunities for professional growth, and the chance to lead impactful healthcare initiatives.