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University Medical Partners

San Jose, California

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Crouse Hospital

Syracuse, New York

University Medical Partners

Pleasanton, California

University Medical Partners - Stanford Medicine

Pleasanton, California

Illinois Health and Hospital Association

Chicago, Illinois

Crouse Health

Syracuse , New York

University Medical Partners - Stanford Medicine

San Ramon, California

University Medical Partners

Pleasanton, California

University Medical Partners - Stanford Medicine

Pleasanton, California

University Medical Partners

Pleasanton, California

Methodist Le Bonheur Healthcare

Memphis, Tennessee

St. Joseph’s Health

Paterson, New Jersey

Hennepin Healthcare

Minneapolis, Minnesota

WellStar Spalding Regional Medical Center

Griffin, Georgia

UVA Health

Charlottesville, Virginia

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Penn State Health

Reading, Pennsylvania

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Medical Director - Health Plan
JOB SUMMARYAccountable for managing Health Plan medical costs and assuring appropriate health care delivery for plans and members. Is accountable to provide professional leadership and direction in the utilization/cost management (UM) and clinical quality improvement (QI) of the Health Plan, as measured by benchmarked UM and QI goals. Works collaboratively as a clinical resource to other plan functions that interface with medical management such as provider relations, member services, benefits, claims management, etc. Carries out medical policies at the Health Plan consistent with NCQA and other regulatory bodies.ESSENTIAL FUNCTIONS OF THE ROL


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