Senior Medical Director - FIDE IL
Core
Lead clinical strategy and oversight for Dual Special Needs Populations (DSNP/FIDE) to improve health outcomes and manage complex care needs.
Role type
Senior Medical Director (Managed Care)
Builds
Clinical programs, care management strategies, and quality improvement initiatives for complex health populations.
Domain
Healthcare / Managed Care / Population Health
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Clinical oversight of complex populations, utilization management, risk adjustment, care management, regulatory compliance, data interpretation, peer review, quality improvement, interdisciplinary collaboration
Preferred skills
Managed care industry experience, leading interdisciplinary teams, evidence-based medicine principles, network physician relationship building
Technologies
None explicitly stated
Responsibilities
Develop and implement clinical initiatives for DSNP/FIDE populations, collaborate with state regulatory agencies and provider communities, lead interdisciplinary care team rounds, participate in state fair hearings and utilization management appeals, support compliance and quality assurance functions, present findings to senior management and external stakeholders
Seniority
Senior, hands-on IC with leadership responsibilities
