Associate Medical Director - Utilization & Care Leadership

Cambia Health; Little Rock (AR); Hybrid; USD 220,000 - 298,000; Full time

Benefits offered by this job

Work from home options for most roles

401(k) with company match

12 weeks paid parental leave

Health savings account contributions

Job summary

Cambia Health is seeking an Associate Medical Director or Medical Director to lead utilization management and provide clinical leadership across teams in multiple offices, including Little Rock. This hybrid role requires in-office presence three days per week and relocation or commutable distance considerations.

The role emphasizes leadership, policy development, and data-driven improvement to deliver higher quality, cost-effective care for members in a four-state area (OR, WA, ID, UT) with

Qualifications

• Licensed Physician with an MD or DO degree
• Active, unrestricted license to practice medicine in one or more states or territories of the United States, with one of these licenses in our four-state area (OR, WA, ID, UT)
• Board Certification required

Responsibilities

• Provide clinical leadership for staff to ensure safe, effective and cost-efficient services.
• Contribute to medical management strategies to drive results and key performance metrics.
• Conduct peer clinical reviews for medical necessity on utilization management requests.
• Provide clinical input on case management reviews with CM staff.
• Discuss peer-to-peer review determinations with providers.
• Lead cross-functional teams on medical policy development and program initiatives.
• Analyze data to improve value for members and employers.

Skills

Medical license

Board certification

Clinical experience

AI tools experience

Education

MD/DO degree

Job description

Cambia Health is seeking an Associate Medical Director or Medical Director to lead utilization management and provide clinical leadership across teams in multiple offices, including Little Rock. This hybrid role requires in-office presence three days per week and relocation or commutable distance considerations.

The role emphasizes leadership, policy development, and data-driven improvement to deliver higher quality, cost-effective care for members in a four-state area (OR, WA, ID, UT) with