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University Medical Partners

San Jose, California

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Syracuse, New York

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Crouse Health

Syracuse , New York

University Medical Partners - Stanford Medicine

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University Medical Partners

Pleasanton, California

University Medical Partners

Pleasanton, California

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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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