Associate Medical Director

Job Summary

The Associate Medical Director is a licensed Physician (MD or DO) and an integral member of the Medical Leadership team, working in partnership with the Chief Medical Officer. This role provides physician-level clinical leadership and oversight to support high standards of patient care quality, utilization management, documentation integrity, and regulatory compliance within ilumed’s value-based care programs.

The Associate Medical Director collaborates closely with Medical, Market Operations, and Provider Relations leadership to drive clinical excellence, optimize provider performance, and ensure alignment with accountable care models (ACO REACH/LEAD, MSSP). This role serves as a peer leader to participating physicians and practices, promoting evidence-based care delivery and performance improvement across markets.

Essential Job Functions

• Provides physician oversight of utilization, quality, and performance analytics across markets, provider groups, and primary care practices to identify trends impacting patient outcomes and financial performance.
• Partners with Operations and Provider Representatives during monthly PCP meetings to guide clinical performance improvement initiatives and action planning.
• Reviews hospital admissions, discharges, emergency department utilization, and readmissions to ensure appropriate transitional care management and continuity of care.
• Collaborates with Case Management and Care Coordination teams to promote appropriate post-discharge services, chronic disease management, and risk mitigation strategies.
• Engages directly with physicians and practice leadership to review performance metrics, address care gaps, and support improvement initiatives aligned with value-based care benchmarks.
• Provides peer-to-peer accountability and clinical leadership to PCPs to ensure performance standards are met while fostering collaboration and professional respect.
• Participates in review and resolution of medical grievances in coordination with internal teams, health plans, and regulatory requirements.
• Assists in conflict resolution related to clinical performance, documentation standards, patient care concerns, and practice operations.
• Educates and mentors PCPs regarding accurate clinical documentation, risk adjustment coding (HCC), quality metric performance, and appropriate technology utilization.
• Promotes best practices in evidence-based medicine, utilization management, and value-based care delivery.
• Supports CMS program compliance requirements associated with ACO REACH, MSSP, and other value-based initiatives.
• Performs other duties as assigned.

Knowledge, Skills and Competencies

• Strong background in clinical practice, healthcare delivery systems, utilization management, and quality improvement.
• Demonstrated understanding of value-based care models, population health, risk adjustment, and financial performance drivers.
• Working knowledge of accountable care programs (ACO REACH/LEAD, MSSP) and CMS regulatory requirements.
• Ability to interpret clinical and utilization data and translate findings into actionable physician-level improvement strategies.
• Strong peer leadership skills with the ability to influence physician behavior through collaboration and credibility.
• Excellent verbal and written communication skills, including ability to present clinical findings to executive leadership.
• Ability to manage multiple priorities in a dynamic healthcare environment.
• Demonstrated sound clinical judgment and professional integrity.
• Maintains confidentiality and adheres to HIPAA and privacy regulations.
• Proficient in Microsoft Office applications and clinical reporting tools.

Education and Experience

• Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) from an accredited medical school.
• Board certified or board eligible in Family Medicine, Internal Medicine, or comparable primary care specialty (Board certification preferred).
• Active, unrestricted medical license in good standing.
• Minimum of five (5) years of clinical practice experience in primary care or comparable specialty.
• Two (2) or more years of physician leadership, medical director, or clinical oversight experience preferred.
• Experience in value-based care, utilization management, quality programs, and data analytics.
• Experience supporting practice transformation initiatives aligned with the “Triple Aim” (quality, cost, patient experience).

Physical Requirements

• Prolonged periods of sitting at a desk and working on a computer.