Regional Medical Director – Nashville

Job Description:

• Manage assigned aspects of medical policies and programs
• Perform medical reviews
• Interact with provider communities for assigned areas
• Provide advanced clinical leadership across medical management programs
• Integrate traditional utilization review with population health, value-based care, and provider-performance initiatives
• Apply medical policy expertise to clinical strategy
• Influence quality, Stars-related performance, affordability, risk adjustment accuracy, and market-level outcomes

Requirements:

• Medical leadership experience and advanced clinical expertise
• Experience with medical policies and programs
• Experience performing medical reviews
• Experience interacting with provider communities
• Knowledge of utilization review
• Knowledge of population health
• Knowledge of value-based care
• Knowledge of provider-performance initiatives
• Ability to influence quality, Stars-related performance, affordability, risk adjustment accuracy, and market-level outcomes
• Must reside within the continental United States, excluding California, New York, Alaska, and Hawaii
• Successful completion of drug screening may be required

Benefits:

• Curated development plans fostering growth and rewarding careers
• Health and wellness benefits
• 401(k) savings plan
• Pension plan
• Minimum of 15 days of paid time off
• Paid parental leave
• Disability insurance
• Supplemental life insurance
• Employee assistance program
• Paid holidays
• Tuition reimbursement
• Other incentives
• Annual incentive bonus plan