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Planned Parenthood of Southern New England

New Haven, Connecticut

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Iowa City, Iowa

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Texas Tech University Health Sciences Center

Lubbock, Texas

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Far Rockaway, New York

Columbia University Mailman School of Public Health/Health Policy and Management Department

New York City, New York

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Saint Louis, Missouri

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St. Croix, U.S. Virgin Islands

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Oakland, California

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Medical Director - Health Plan
JOB SUMMARYAccountable for managing Health Plan medical costs and assuring appropriate health care delivery for plans and members. Is accountable to provide professional leadership and direction in the utilization/cost management (UM) and clinical quality improvement (QI) of the Health Plan, as measured by benchmarked UM and QI goals. Works collaboratively as a clinical resource to other plan functions that interface with medical management such as provider relations, member services, benefits, claims management, etc. Carries out medical policies at the Health Plan consistent with NCQA and other regulatory bodies.ESSENTIAL FUNCTIONS OF THE ROLEIdentify opportunities for corrective action plans to address issues and improve p


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