Health Plan Medical Director Physician - MedStar Family Choice, Maryland

Medstar Health; Baltimore (MD); Remote; USD 240,000 - 285,000; Full time

Job summary

An established industry player is seeking a skilled Medical Director for its Medicaid Managed Care organization. This remote opportunity invites a physician with a strong background in primary care and health plan operations. You'll be responsible for overseeing case management and utilization review, ensuring that healthcare delivery meets the highest standards of quality and efficiency. Join a respected health system that values your expertise and offers a competitive salary along with comprehensive benefits, including medical, dental, and generous paid time off. Embrace this chance to make a significant impact in the healthcare landscape while enjoying a fulfilling work-life balance.

Benefits

Medical, dental, and vision insurance

Paid licensing and malpractice insurance

Generous paid time off

CME leave and allowance

Retirement plan with employer match

Qualifications

• At least 5 years of clinical experience with leadership responsibilities.
• Health plan experience is preferred.

Responsibilities

• Developing and executing case management and disease management.
• Reviewing inpatients, precertification requests, and pharmacy requests.

Skills

Clinical Experience

Leadership Responsibilities

Health Plan Operations

Utilization Review

Education

Medical License in DC

Medical License in Maryland

Job description

Health Plan Medical Director Physician - MedStar Family Choice, Maryland - Remote Opportunity

MedStar Health offers a rewarding career in a major marketplace. Join an organization that values your experience as a clinician and healthcare expert.

We seek a physician with primary care and health plan experience for the role of Medical Director at MedStar Family Choice, our Medicaid Managed Care organization in Baltimore, MD. Responsibilities include developing and executing case management, disease management, population health, utilization review, and other health plan operations. Daily tasks involve reviewing inpatients, precertification requests, pharmacy requests, emergency visits, appeals, and consulting with nurse case managers to ensure smooth operations. Utilization decisions are based on UM criteria, medical necessity, and coverage.

Qualifications include at least 5 years of clinical experience with leadership responsibilities; health plan experience is preferred. Candidates must reside in the DC/Maryland area and hold medical licenses in DC and Maryland.

Remote Telehealth Opportunity

As a MedStar associate, you can expect:

• Competitive salary
• Medical, dental, and vision insurance
• Paid licensing and malpractice insurance
• Generous paid time off
• CME leave and allowance
• Retirement plan with employer match

Join a nationally recognized health system—MedStar Health, the largest provider in Maryland, with extensive resources to advance your clinical expertise. Enjoy a fulfilling career and quality of life in the Mid-Atlantic region, with diverse urban, suburban, and rural communities.

MedStar Health employs over 30,000 associates across hospitals and care sites, ranked among the "Best Places to Work" by local publications. We are committed to equity and diversity, fostering an inclusive environment where all feel valued and empowered.

Position salary range: $240,000 - $285,000.