Medical Director, Utilization Management-Remote Alignment Healthcare IncMedical Director, Utilization Management-RemoteCARemote$262,145–$393,217 / yearThe UM Medical Director/Physician Advisor works with UM licensed staff, Regional Medical Officers and Extensivists to develop and implement methods to optimize use of Institutional and Outpatient services for all patients while also ensuring the quality of care provided. GENERAL DUTIES/RESPONSIBILITIES (MAY INCLUDE BUT ARE NOT LIMITED TO): Second level reviews in compliance with Medicare/CMS: NCD, LCD and Milliman guidelines for Inpatient, Outpatient, Skilled Facilities Level of Care and Pharmacy.
Medical Director, Utilization Management Alignment Healthcare IncMedical Director, Utilization ManagementCAThe UM Medical Director/Physician Advisor works with UM licensed staff, Regional Medical Officers and Extensivists to develop and implement methods to optimize use of Institutional and Outpatient services for all patients while also ensuring the quality of care provided. GENERAL DUTIES/RESPONSIBILITIES (MAY INCLUDE BUT ARE NOT LIMITED TO): Second level reviews in compliance with Medicare/CMS: NCD, LCD and Milliman guidelines for Inpatient, Outpatient, Skilled Facilities Level of Care and Pharmacy.
Associate Ob/Gyn Medical Director East Valley Community Health CenterAssociate Ob/Gyn Medical DirectorWest Covina, CA$257,088–$283,414 / yearMAJOR POSITION RESPONSIBILITIES AND FUNCTIONS: The Associate OBGYN Medical Director will: Have administrative responsibilities and will work in conjunction with the Chief Medical Officer (CMO) and as required, with the Chief Operating Officer (COO). Provide necessary trainings to OBGYN medical providers and other staff members in order to ensure compliance with EVCHC clinical policies and procedures, health plan and contract clinical guidelines.
Associate OB/GYN Medical Director EAST VALLEY COMMUNITY HEALTH CENTER INCAssociate OB/GYN Medical DirectorWest Covina, CA$257,088–$283,414 / yearMAJOR POSITION RESPONSIBILITIES AND FUNCTIONS: The Associate OBGYN Medical Director will: Have administrative responsibilities and will work in conjunction with the Chief Medical Officer (CMO) and as required, with the Chief Operating Officer (COO). Provide necessary trainings to OBGYN medical providers and other staff members in order to ensure compliance with EVCHC clinical policies and procedures, health plan and contract clinical guidelines.
Associate OB/GYN Medical Director EVCHC WebsiteAssociate OB/GYN Medical DirectorWest Covina, CaliforniaProvide necessary trainings to OBGYN medical providers and other staff members in order to ensure compliance with EVCHC clinical policies and procedures, health plan and contract clinical guidelines. Provide supervision and leadership to the clinical staff within the OBGYN department at all EVCHC sites and implement necessary activities to ensure a high level of care.
NewMedical Director - Echo Park Veterinary Hospital PetVet Care CentersMedical Director - Echo Park Veterinary HospitalLos Angeles, CA$200,000–$250,000 / yearEcho Park Veterinary Hospital For veterinarians who enjoy both practicing medicine and leading others, serving as a Medical Director in a Los Angeles small animal practice can be a rewarding career path that combines clinical excellence, mentorship, strategic leadership, and the ability to make a lasting impact on both the veterinary profession and the local community. Becoming a Veterinary Medical Director of a small animal general practice in Los Angeles, California, offers the opportunity to combine clinical medicine with leadership while making a meaningful impact on patients, clients, and the veterinary team.
Director, Field Medical/Medical Science Liaison - West KardiganDirector, Field Medical/Medical Science Liaison - WestLos Angeles, California$265,000–$345,000 / yearThe individual acts as a scientific expert in cardiovascular disease (e.g., heart failure, cardiomyopathies, hypertension, cardiometabolic disease, etc.), builds trusted partnerships with key opinion leaders (KOLs), and implements the Cardiovascular Medical Strategy locally. Provide clinical trial support for company sponsored trials, facilitating relevant medical activities and working cross-functionally with Medical Affairs and Clinical Operations colleagues.
Medical Director, Utilization Management L.A. Care Health PlanMedical Director, Utilization ManagementLos Angeles, CAThis position plays a critical role in the mitigation of Fraud, Waste and Abuse (FWA) and requires proactive analysis of service level utilization data to identify trends, outliers and emerging risk areas and recommend corrective action to minimize utilization variation, prevent improper payments and ensure financial stewardship. Job Summary The Medical Director, Utilization Management provides clinical oversight of authorization decision making and processing, pre and post payment claims review activities, payment integrity clinical validation and program integrity functions.
NewPhysician (MD/DO) - Medical Director/Supervising Physician COPE HEALTH SOLUTIONSPhysician (MD/DO) - Medical Director/Supervising PhysicianLos Angeles, CA$240,000–$260,000 / yearThe Medical Director partners closely with the Advanced Practice Provider (APP), Registered Nurse (RN), Licensed Clinical Social Worker (LCSW), Pharmacist, Community Health Worker (CHW), and Care Navigators to ensure delivery of high-quality, evidence-based, patient-centered care for individuals with complex medical, behavioral, and social needs. The Medical Director provides physician supervision and consultation, supports clinical decision-making and care planning, oversees quality and patient safety initiatives, and collaborates with primary care providers to improve health outcomes, reduce avoidable utilization, and achieve performance goals within value-based care programs.
Medical Director - Radiation Oncology - MD or DO CVS Health CorpMedical Director - Radiation Oncology - MD or DOCA$174,070–$374,920 / yearThe Radiation Oncology Medical Director supports the CVS Health Specialty oncology business in managing oncology specific utilization of providers, clinical reviews of oncology specific data, and assist with growing our oncology footprint. In the Medical Director role, you will provide oversight for medical policy implementation; you will support the ensuring timely and consistent responses to members and providers; you will focus on prior authorization cases and consultation cases.
NewMedical Director- Shatto Veterinary Center PetVet Care CentersMedical Director- Shatto Veterinary CenterLos Angeles, CA$200,000–$265,000 / yearShatto Veterinary Center in the vibrant city of Los Angeles, California, near Koreatown, has been committed to providing the highest level of care and compassion to our beloved animal companions since their establishment in 2016. We are offering a Generous Medical Director Salary of $200,000 - $265,000, Quarterly No Deficit Carry Over Production based bonus structure, an Annual Medical Director Stipend & Signing, Retention and Relocation packages up to $125,000.
Senior Medical Director - Medical Safety Evaluation Mitsubishi Tanabe PharmaSenior Medical Director - Medical Safety EvaluationLos Angeles, CAProvides primary liaison between global/local groups and external groups (Drug Safety Monitoring Boards, regulatory agencies, physician communities, and CROs) on product safety related issues as assigned. Works with medical affairs team to build awareness of the safety of company products in the medical community, including supporting company sponsored Advisory Boards, participating in medical symposia, publishing, attending media events, and other activities.
Medical Director The Cigna GroupMedical DirectorCA$230,600–$384,400 / yearPOSITION SUMMARY: As an Inpatient Medical Director, you'll provide critical clinical insight across the enterprise supporting the effectuation of MCG guidelines for level of care appropriateness You'll have the opportunity to partner with leaders across all business units including Express Scripts and Evernorth to develop solutions to some of the greatest challenges in health care. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.
Primary Care Medical Director (MD/DO) - Los Angeles Haven Health Group, Inc.Primary Care Medical Director (MD/DO) - Los AngelesLos Angeles, CA$165,000–$245,000 / yearThis role comes with a genuine path to ownership, structured in two parts: Practice (PC) Ownership Track: As California law requires that a professional medical corporation be owned by a licensed physician, this role includes the opportunity to become a physician-owner of Haven Health Group Los Angeles, P.C. over time, subject to applicable corporate practice of medicine requirements and definitive documentation. This is a dual role: you'll manage your own patient panel, delivering hands-on primary care, and you'll hold clinical and regulatory oversight of the practice, including supervision of physician assistants and nurse practitioners, ownership of clinical protocols, and quality assurance.
Medical Director Peregrine Health IncMedical DirectorCAEstablish clear clinical protocols, decision frameworks, and escalation pathways for scenarios involving partners, providers, and patients, including crisis protocols and legal escalations (Board of Nursing, subpoenas, partner executives, etc.). Peregrine is a fast-growing behavioral health services and technology platform that partners with Federally Qualified Health Centers (FQHCs) and Community Health Centers (CHCs) to expand access to high-quality mental health and substance use disorder care.
Site Medical Director APLA Health & WellnessSite Medical DirectorLos Angeles, CAPOSITION SUMMARY: Under the direction of the Chief Medical Officer (CMO) the Site Medical Director supports their site's medical provider team to achieve high job performance and satisfaction; assists the CMO to ensure access to high-quality medical services for APLA Health & Wellness patients at their clinical site. REQUIREMENTS: Possession of a Doctor of Medicine (M.D.) or Doctor of Osteopathic Medicine (DO) Degree and a valid license to practice medicine issued by the California Medical Board with no pending or previous disciplinary action from any state licensing entity.
UM Medical Director DME - Pacific or Mountain Time Zone preferred - Remote UnitedHealth Group IncUM Medical Director DME - Pacific or Mountain Time Zone preferred - RemoteLos Angeles, CARemote$248,500–$373,000 / yearThe Medical Director's activities primarily focus on the application of clinical knowledge in various utilization management activities with a focus on pre-service benefit and coverage determination or medical necessity (according to the benefit package), and on communication regarding this process with both network and non-network physicians, as well as other Enterprise Clinical Services. The Medical Director collaborates with Enterprise Clinical Services leadership and staff to establish, implement, support, and maintain clinical and operational processes related to benefit coverage determinations, quality improvement and cost effectiveness of service for members.
Behavioral Health Medical Director - Psychiatrist - California Medicaid (Part-Time) Elevance Health IncBehavioral Health Medical Director - Psychiatrist - California Medicaid (Part-Time)Woodland Hills, CA$178,135–$290,437.50 / yearMinimum Requirements: Requires MD or DO and Board certification approved by one of the following certifying boards is required, where applicable to duties being performed, American Board of Medical Specialties (ABMS) or American Osteopathic Association (AOA). Key responsibilities include monitoring and analyzing behavioral health trends within the health plan, serving as a clinical advisor and thought leader through ongoing collaboration with health plan partners, and providing support to behavioral health UM and case management teams beyond individual case reviews.
NewUM Medical Director DME - Pacific Or Mountain Time Zone Preferred - Remote UnitedHealth Group Inc.UM Medical Director DME - Pacific Or Mountain Time Zone Preferred - RemoteLos Angeles, CARemote$248,500–$373,000 / yearThe Medical Director's activities primarily focus on the application of clinical knowledge in various utilization management activities with a focus on pre-service benefit and coverage determination or medical necessity (according to the benefit package), and on communication regarding this process with both network and non-network physicians, as well as other Enterprise Clinical Services. The Medical Director collaborates with Enterprise Clinical Services leadership and staff to establish, implement, support, and maintain clinical and operational processes related to benefit coverage determinations, quality improvement and cost effectiveness of service for members.
Physician Urgent Care Medical Director ConcentraPhysician Urgent Care Medical DirectorCity Of Industry, California$280,000–$330,000 / yearMonitors key clinical center metrics that are provided by Clinical Analytics and relate to quality outcomes: Practice Indicators, COP, GRV, LOS, TAT, Specialist Referral Rate, Primary Care Case Duration, Days to First Recheck, % of cases with Lost Time, Limited Duty, and Full Duty. The Center Medical Director supports the Director of Medical Operations by providing exceptional clinical care delivery within the center, consistent with Concentra’s clinical model, and ensuring optimal clinical outcomes for our workforce patient population.