Medical Director – Care & Case Management

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🔥 6 minutes ago

🇺🇸 United States – Remote

💵 $240.7k - $368.3k / year

⏰ Full Time

🔴 Lead

👨‍⚕️ Medical Director

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Included Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

☁️ SaaS

👥 HR Tech

Healthcare • SaaS • HR Tech

Included Health is a healthcare technology company that delivers personalized, employer- and health-plan-focused primary, urgent, and behavioral health care through a single app and a network of virtual and in-person services. It blends AI-driven tools and human care teams to provide 24/7 care coordination, billing and claims advocacy, second opinions from leading specialists, and mental-health support, with the goal of lowering employer healthcare costs and improving member experience and inclusivity.

📋 Description

• Lead the care, case, and utilization management programs and set clinical direction • Own program outcomes, performance, and quality targets for Included Health’s CCM and UM programs • Serve as the clinical escalation point for care, case, and utilization management programs • Set and maintain clinical standards, evidence-based care pathways, and clinical quality expectations • Own clinical KPIs, evaluate performance gaps, and redesign workflows to close them • Analyze data, identify outliers and ineffective workflows, and drive resolution and improvement • Run weekly performance reviews, escalation triage, and action tracking • Evolve the clinical operating model across adult, maternity, and pediatric populations • Partner with Product and Engineering to design, validate, and deploy AI and agentic tools into clinical workflows • Build new programs and models of care and define how they scale across populations and clients • Lead, manage, and develop clinical leaders and teams • Conduct performance reviews, coaching, and feedback for direct reports • Attract and retain a strong, diverse pool of clinicians and talent • Coordinate care with clinical leaders and cross-functional stakeholders for members with multi-specialty needs • Represent care management in cross-functional initiatives, pilots, and strategic planning related to complex care • Implement quality assurance processes with the Quality team • Report to the Senior Medical Director, Complex Care

🎯 Requirements

• Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO) • Board certified in internal medicine, family medicine, med-peds, or a related specialty • Minimum of 7 years of post-residency clinical experience • Minimum of 5 years in a healthcare leadership role with direct oversight of clinical teams or programs • Experience managing other clinical leaders (managing managers) • Active, unrestricted medical license in good standing in state of residence • Active multi-state licensure or willingness to obtain it • Track record of delivering against operational KPIs, such as productivity, clinical quality, and engagement, in a scaled, performance-driven setting • Experience working in digital health or virtual care delivery models preferred • Comfort integrating clinical AI tools into day-to-day workflows and care delivery preferred • Knowledge of medical, behavioral, and social factors driving poor outcomes and avoidable cost across complex populations preferred • Living in a physician compact-eligible state preferred

🏖️ Benefits

• Remote-first culture • 401(k) savings plan through Fidelity • Comprehensive medical, vision, and dental coverage through multiple medical plan options, including disability insurance • Paid Time Off (PTO) • Discretionary Time Off (DTO) • 12 weeks of 100% Paid Parental leave • Fertility coverage • $25,000 for surrogacy/adoption • Paid leave for failed treatments, adoption or pregnancies • Work-From-Home reimbursement to support team collaboration home office work • Bonus • Equity