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Regional Medical Director

Role overview

Qualifications

  • Physician with a current and unrestricted license in a US state or territory
  • Board Certification as an M.D. or D.O. by an ABMS-approved specialty board or Osteopathic board
  • Minimum 5 years of clinical experience
  • Analytical and communication skills

Responsibilities

  • Responsible for assigned aspects of medical policies and programs; performs medical reviews and interacts with provider communities for assigned areas
  • Provides advanced clinical leadership across medical management programs, integrating traditional utilization review with strategic population health, value-based care, and provider-performance initiatives
  • Aligns medical policy expertise with forward-leaning clinical strategy to influence quality, Stars-related performance, affordability, risk adjustment accuracy, and market-level outcomes
  • Collaborates with cross-functional teams to implement and monitor medical management initiatives

About the company

CareAllies logo

CareAllies

Hospitals & Health Care

CareAllies works side-by-side with health care providers to help improve the quality, value and experience of care for their patients, to make health care better for everyone. Our aim: To support doctor-patient-community engagement to enhance the quality and affordability of care. This is how physicians and health systems will deliver sustainable value-based care and continue to thrive in the future. CareAllies has the flexibility to help you get there. No matter where you’re starting from. All CareAllies products and services are provided exclusively by or through CareAllies, Inc. The CareAllies name, logo, and other CareAllies marks are owned by Cigna Intellectual Property, Inc. As to CareAllies content/properties, © 2016 CareAllies, Inc. All rights reserved. www.careallies.com/legal.

Company details

IndustryHospitals & Health Care
Company size501 - 1000

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Job description

At CareAllies, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Job Summary

This position is responsible for assigned aspects of medical policies and programs. Performs medical reviews and interacts with the provider communities for assigned areas. Provides advanced clinical leadership across medical management programs, integrating traditional utilization review with strategic population health, value-based care, and provider-performance initiatives. Aligns medical policy expertise with forward-leaning clinical strategy to influence quality, Stars-related performance, affordability, risk adjustment accuracy, and market-level outcomes.

Required Job Qualifications:

  • Physician with a current and unrestricted physician license in a state or territory of the United States.
  • Maintain Board Certification as a M.D. or D.O. (by a specialty board approved by the American Board of Medical Specialties (doctors of medicine); or the Advisory Board of Osteopathic Specialists (doctors of osteopathic medicine)
  • 5 years of clinical experience
  • Analytical and communication skills
  • Strategic thinking skills

Preferred Job Qualifications:

  • Ability to travel
  • 3 years Managed Care experience
  • IPA (independent Physician Association) MSO or Value Based Enablement Organization Experience
  • Advanced skills in clinical interpretation, communication, data-driven strategy, and collaborative leadership
  • Experience with Stars performance, risk adjustment education, or provider engagement
  • Experience in matrixed environments and cross-functional clinical leadership.

EEO Statement:

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

Pay Transparency Statement:

At CareAllies, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, a minimum of 15 days’ of paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for full-time employees.

The salary offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

Min to Max Range:

$191,500.00 - $355,600.00

Exact compensation may vary based on skills, experience, and location.

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MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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