Medical Director

Job not on LinkedIn

🔥 1 minute ago

🏄 California – Remote

🏄 California – Remote

💵 $222.8k - $267.3k / year

⏰ Full Time

🔴 Lead

👨‍⚕️ Medical Director

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Altais

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2019

🏥 Healthcare

👥 B2C

🧘 Wellness

Healthcare • B2C • Wellness

Altais is a California-based healthcare provider network that unifies multiple medical brands to offer coordinated primary care, urgent care, specialty services, hospitals and labs, and mental and senior health across Northern and Southern California. The organization supports physicians and care teams with technology-enabled patient portals and value-based care partnerships, serving patients directly while also working with providers and partners to improve access, affordability, and care coordination.

📋 Description

• Report directly to the Senior Medical Director with a dotted line to the Chief Officer for Health and Innovation • Ensure delivery of high-quality, efficient and comprehensive healthcare services throughout the continuum of care • Develop and implement Utilization Management policy and procedures • Enhance efficiency and quality of care through effective network management • Develop and maintain collaborative relationships with key providers and thought leaders • Provide leadership and direction to UMC primary care and specialist physicians • Co-chair utilization management, quality management, peer review and patient safety committees as needed • Interface with health plans regarding benefits, coverage issues, appeals and HMO hearings • Manage care in a cost-containment manner without compromising health outcomes • Facilitate clinical rounds with Case Managers and Management to meet bed day performance goals • Engage network physicians regarding performance, cost, clinical appropriateness and authorizations • Develop UM policies, authorization review criteria and physician education forums • Address case management problems and participate in IDCT Meetings • Support physician education on UM and provide input into UM goals and objectives • Coordinate prospective, concurrent and retrospective review, including denial or approval of outside medical service referrals • Develop and maintain written medical care protocols and assure UM standardization • Conduct chart reviews for appropriateness of applying clinical guidelines • Serve as physician-to-physician liaison for UM-related issues • Prepare and review Decision Validation Criteria as required by UM • Attend required UM, health plan, hospital and One Altais meetings

🎯 Requirements

• Doctor of Medicine degree • Valid California licensure • Current Board certification, preferably in a broad based specialty such as Internal Medicine, Family Practice, Emergency Medicine, Geriatrics, General Surgery or Pediatrics • Minimum of twelve (12) years as a practicing inpatient and outpatient physician in a managed care environment • Active and in good standing unrestricted MD licensure in the state of California • External hires must pass a background check/drug screen

🏖️ Benefits

• Excellent medical, vision, and dental coverage • 401k savings plan with a company match • Flexible time off and 9 Paid Holidays • Eligible to participate in the annual bonus program • Competitive compensation package • Robust benefits program