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REMOTE - Associate Medical Director, Health Plan

REMOTE - Associate Medical Director, Health Plan

Martin's PointPortland, ME, United States
18 days ago
Job type
  • Full-time
  • Remote
Job description

Join Martins Point Health Care, an innovative, not-for-profit organization recognized as a

Great Place to Work since 2015. Our mission is simple : people caring for people. Together, we provide care and coverage to communities across Maine and beyondtransforming health care while building healthier communities.

Were seeking a Medical Director to provide clinical leadership for our Health Plans. In this role, youll partner with leaders across Utilization and Care Management, Health Management, Compliance, Network Management, and beyond to ensure high-quality, cost-effective care for our members. Youll help shape clinical programs, influence quality and performance outcomes, and guide medical policy development.

What youll do :

Lead clinical oversight for utilization and care management

Review medical necessity, appeals, and disputes for clinical appropriateness

Drive quality improvement and support accreditation standards (NCQA, CMS, TRICARE)

Partner with Informatics and Medical Economics on provider performance and cost management

Contribute to ACO strategy, risk adjustment, and overall Health Plan performance metrics

What were looking for :

Board-certified physician with clinical practice experience

Background in health plan leadership, utilization management, or Medicare Advantage / TRICARE preferred

Strong analytical, strategic, and relationship-building skills

Active medical license (Maine, NH, or eligible to obtain)

At Martins Point, we value trust, respect, continuous learning, and even a little fun. If youre a physician leader ready to make an impact on health care delivery at the system level, wed love to meet you.

Apply today and discover why people love working at Martins Point.

This position is not eligible for immigration sponsorship.

We are an equal opportunity / affirmative action employer.

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Associate Medical Director • Portland, ME, United States