Medical Director – Casual

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🏄 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 to the Senior Medical Director, with a dotted line to the Chief Officer for Health and Innovation • Support 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 patient care through effective network management • Develop and maintain collaborative relationships with key providers and physician thought leaders • Provide leadership and direction to Utilization Management Committee primary care and specialist physicians • Co-chair committees including Utilization Management, Quality Management, Peer Review and Patient Safety, as needed • Interface with health plans regarding benefits, coverage issues, appeals, HMO hearings, and unresolved administrative issues • Manage patient 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 and promote managed care systems within One Altais • Identify authorization-review criteria and educate primary care and specialist physicians on utilization management systems • Serve as a resource for case management problems and participate in Interdisciplinary Care Team meetings • Support physician education on Utilization Management and contribute to UM goals and objectives • Coordinate prospective, concurrent, and retrospective reviews, including denial or approval of outside medical-service referrals • Develop and maintain written medical-care protocols and ensure Utilization Management standardization • Conduct chart reviews for appropriateness of clinical-guideline application • Act as physician-to-physician liaison for Utilization Management issues • Prepare and review Decision Validation Criteria as required by Utilization Management • Attend required UM Committee, Health Plan Joint Operations, Hospital Joint Operations, 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 • Interest and experience in utilization management and medical management • Ability to work operating business hours on Pacific Standard Time • 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 • 9 Paid Holidays • Competitive compensation package • Background check/drug screen for external hires