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Associate Medical Director

Associate Medical Director

HealthEcareers - ClientCarson, California, United States
1 day ago
Job type
  • Full-time
Job description

Summary Information

Job # :   26644

Work Location :

US  –  Los Angeles ,  CA

Salary :   $123500-302600 Annually

Work Hours :

Monday – Friday, 8 : 00am – 5 : 00pm PST; additional weekends and holiday coverage prn as business needs arise

Job Type : 2 – Staff : Career

Duration :   Indefinite

Posted Date : September 17, 2025

Description

Are you passionate about evidence-based medicine and improving care for Medicare Advantage members? UCLA Health Medicare Advantage Plan is looking for a dedicated and forward-thinking Associate Medical Director to help shape the future of our plan.

In this key leadership role, you’ll work closely with the UHMAP Medical Director and play a vital part in developing and guiding clinical policy that’s grounded in the latest scientific research and Medicare guidelines. Your work will directly support our Health Services Department in delivering high-quality, appropriate, and patient-centered care.

What you’ll do :

  • Lead the development, implementation, and training of medical policies.
  • Provide clinical determinations for UM (prior authorizations, concurrent reviews, appeals, grievances, peer-to-peer).
  • Support day-to-day UM and Clinical Appeals operations.
  • Partner with clinical and operational leaders to ensure high-quality, cost-effective care.
  • Collaborate with the Pharmacy team on safe, effective medication use; participate in drug review rounds and P&T Committee.
  • Contribute to interdisciplinary care team rounds for complex case management.
  • Serve as clinical SME for network / provider relations and present at provider education sessions.

Salary Range : $123,500-302,600 / annually

Qualifications

We’re seeking a dynamic and strategic individual with :

  • MD or DO degree, required
  • Active, unrestricted California State Medical License, required
  • Completion of residency in an adult-based primary care specialty (e.g., Internal Medicine, Family Medicine, Geriatrics), required
  • Board Certification in an ABMS, ABOS, or AOA-recognized specialty (preferably Internal Medicine or Family Medicine), required
  • 5 or more years of direct patient care experience post residency, required
  • Minimum of 2 years medical leadership experience, required
  • Minimum of 2 years of experience in Utilization Management, required
  • Minimum of 2 years in developing evidence-based guidelines, medical policies, or conducting systematic literature review, required
  • 2 or more years of experience working within a health plan, required
  • Knowledge of Medicare Advantage experience with utilization management, quality improvement, or case management, required
  • Familiarity with evidence-based guidelines, MCG / InterQual, and ICD / CPT coding, preferred
  • Experience with population health and CMS STAR ratings, preferred
  • Ability to lead and influence in a matrixed organizational structure
  • Mastery of clinical policy development and application

    • Compensation Information :

    $123500.00 / Annually - $302600.00 / Annually

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    Associate Medical Director • Carson, California, United States