Medical Director

  • Compensation: $275,000.00 - $330,000.00 per year
  • Required Qualifications:
  • City/State: Los Angeles, CA

The largest HMO in Southern California is looking for their next Medical Director!

This HMO has it down- do things right and success follows. They understand what it means to create meaningful interaction between physicians so that patient care is the best it can be, and providers are happy in their role.

Have you been in a role where you sit behind a computer and don't create real relationships with other humans?

You'll find this position is "people-centric" and if you're looking for a role where you can look someone in the eyes and shake hands, we want to talk with you.

You’ll be joining with the security of knowing this organization isn’t going anywhere with

  • over 500,000 members to date
  • a strong leadership team (the current director has been in her role over 10 yrs)
  • over 2500 physicians
  • multiple locations from LA to San Diego

As the Medical Director you'll be:

  • Heading the Case Management team creating and approving care plans
  • Educating PCPs and their staff on HCC and quality metrics
  • The lead expert on HCC coding
  • Sharing knowledge on preventing financial risk
  • Building relationships and shaking hands with providers
  • Flexing your skills working through prior auths, formulary exceptions, and concurrent review
  • The decision-maker on medical necessity

This plan needs someone

  • Well-versed in the managed care space
  • Willing to be "boots on the ground", shaking hands in LA
  • Understands HCC coding
  • Comfortable providing guidance and direction to physicians

Your expertise in health plan reimbursement will shine like a candle as the Medical Director with this hugely successful HMO!