Medicare Medical Director
Core
Lead clinical, quality, care management, and population health strategies for a Medicare Advantage population to improve outcomes and reduce costs.
Role type
Senior Medical Director (Medicare Advantage)
Builds
Clinical engagement strategies, quality improvement programs, and care management initiatives for primary and specialty care settings.
Domain
Healthcare / Medicare Advantage / Population Health
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Clinical patient care, quality improvement, cost containment, population health management, risk adjustment, provider network engagement, strategic stakeholder management
Preferred skills
Utilization review, quality assurance, case management, buy-in generation with clinician stakeholders
Technologies
None stated
Responsibilities
Oversee clinical and quality metrics for the Medicare population; assess opportunities for program enhancements; lead clinical engagement with the Chief Medical Officer; improve clinical documentation and risk adjustment; develop relationships with physicians to disseminate best practices; collaborate with organizational partners to optimize quality initiatives; act as liaison to network providers; provide alternative approaches to improve practice performance.
Seniority
Senior, hands-on IC with strategic leadership