Health Plan Medical Director Physician - MedStar Family Choice, Washington, DC

MedStar Health’s Washington Hospital Center; Washington (District of Columbia); Remote; USD 240,000 - 285,000; Full time

Job summary

MedStar Health is seeking a Health Plan Medical Director Physician to join its Medicaid Managed Care organization in Washington, DC. This remote opportunity involves overseeing case management and health plan operations, requiring significant clinical experience and leadership skills. The role offers a competitive salary and a range of benefits including medical insurance and paid time off.

Benefits

Competitive salary

Medical, dental, and vision insurance

Paid medical 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 progressively responsible leadership roles.
• Health plan experience preferred.
• Must hold medical licenses in DC and Maryland.

Responsibilities

• Develop and execute case management and population health management.
• Review inpatients, precertification requests, and pharmacy requests.
• Consult with nurse case managers to ensure smooth daily operations.

Skills

Leadership

Clinical Expertise

Health Plan Management

Job description

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

MedStar Health offers a rewarding career in a major marketplace. Shape your future in healthcare in a setting that suits you and your practice. Join an organization that values your experience and input as a clinician and healthcare expert.

We seek a physician with primary care and health plan experience to join MedStar Family Choice, our Medicaid Managed Care organization, as the Medical Director in the Washington, DC area. Responsibilities include developing and executing case management, disease management, population health management, utilization review, and other operations of the health plan. The role involves reviewing inpatients, precertification requests, pharmacy requests, emergency visits, appeals, and consulting with nurse case managers to ensure smooth daily operations. Utilization decisions will be based on UM criteria, medical necessity, and coverage.

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

This is a remote telehealth position.

Benefits of being a MedStar Health associate:

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

Join a nationally recognized health system and the largest provider of health services in the Washington, DC region. Expand your clinical expertise with our vast resources. Enjoy a rich career and quality of life in the Mid-Atlantic, with urban, suburban, and rural communities.

MedStar Health is the largest health system in the region, with 30,000 associates, 10 hospitals, hundreds of ambulatory sites, over 700 access points, and coverage across 225+ zip codes in 17 counties. We are ranked among the “Best Places to Work” by Baltimore magazine, Baltimore Business Journal, and Washington Business Journal.

We are committed to equity and diversity, fostering an inclusive workplace where all feel a sense of belonging and achievement. We believe diverse teams lead to better care and a stronger organization, aligning with our SPIRIT values of teamwork, respect, and open communication.

This position offers a salary range of $240,000 - $285,000.