Medical Director

TEEMA; Phoenix (AZ); Remote; USD 193,000 - 200,000; Full time

Benefits offered by this job

Remote work

Career progression

Clinical practice flexibility

Job summary

TEEMA seeks a Medical Director specializing in Surgery, Orthopedics, or PM&R to provide strategic clinical leadership for TriWest Healthcare Alliance. This role focuses on utilization management, medical necessity reviews, and governance with a dual-practice model: 75% remote administration and 25% external clinical practice.

Expect high impact, fast-paced execution, and collaborative leadership. The successful candidate holds an MD/DO with board certification in General Surgery, Orthopedic

Qualifications

• MD or DO with board certification in surgery, orthopedics, or PM&R.
• Active unrestricted state medical license.
• Proven executive leadership in medical direction or equivalent.

Responsibilities

• Lead utilization management and medical necessity reviews for network.
• Oversee appeals and peer-review processes with providers.
• Develop policies for clinical governance and quality oversight.
• Collaborate with operations, provider relations, and leadership.
• Monitor KPIs and ensure regulatory/compliance alignment.
• Maintain 75% administrative leadership and 25% external clinical practice.

Skills

Utilization Management

Medical Necessity Reviews

Executive Leadership

Education

MD/DO

Board Certification in General Surgery, Orthopedic Surgery, or PM&R

Tools

EMR Systems

Quality Assurance

Job description

Medical Director – Surgery, Orthopedics & PM&R

Role Summary

Are you an accomplished physician leader seeking a prestigious, high-impact executive position with a strong work-life balance? We are actively recruiting a Medical Director specializing in Surgery, Orthopedics, or Physical Medicine & Rehabilitation (PM&R) to provide strategic clinical leadership for TriWest Healthcare Alliance. This physician executive role focuses completely on utilization management, medical necessity reviews, appeals, and clinical governance supporting military members, veterans, and their families. To ensure our leaders maintain sharp, active clinical judgment, this position features a unique dual-practice model: you will dedicate 75% of your time (3 days per week) to TriWest's remote administrative operations and 25% (1 day per week) to your own private practice or locum tenens work. Step into a highly collaborative, tech-forward infrastructure where your specialized medical insights drive macroscopic healthcare transformation.

Duties & Responsibilities

Clinical Governance & Utilization Review

Coverage Determinations: Evaluate complex surgical, orthopedic, rehabilitation, and specialty care cases, making accurate coverage and medical necessity determinations based on evidence-based guidelines.

Appeals & Peer Reviews: Direct robust clinical appeals reviews and conduct collaborative peer-to-peer discussions with network providers.

Policy Development: Provide expert clinical guidance to support the development, enhancement, and implementation of healthcare policies and quality oversight structures.

Operational Collaboration: Partner closely with clinical operations, provider relations, quality management, and executive leadership teams to optimize network performance.

Performance Frameworks: Monitor key performance indicators (KPIs) and quality metrics to align workflows with regulatory compliance and accreditation standards.

Dual-Practice Integration: Actively maintain an outside clinical footprint (1 day per week) in your specialty field to continuously inform your executive decision-making with modern practice standards.

Other duties as assigned.

Required Qualifications

Educational Credentials: Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO) degree.

Board Certification: Current Board Certification in General Surgery, Orthopedic Surgery, or Physical Medicine & Rehabilitation (PM&R).

Licensure: An active, unrestricted state medical license.

Executive Leadership: Previous experience as a Medical Director, Associate Medical Director, Chief Medical Officer, Department Chair, Physician Advisor, or Physician Reviewer.

Managed Care Competency: Strong experience in Utilization Management (UM), Medical Necessity Reviews, Appeals Reviews, and health plan/managed care frameworks.

Geographic Alignment: Must currently reside in an approved TriWest work state.

Practice Split Commitment: Full agreement to maintain a split schedule consisting of 75% (3 days) administrative leadership with TriWest and 25% (1 day) active external clinical practice.

Desired Qualifications

Government Healthcare Expertise: Prior experience working with TRICARE, the Defense Health Agency (DHA), Department of Defense (DoD), Veterans Affairs (VA), or Military Treatment Facilities (MTFs) is highly preferred.

Network Management: Experience supporting geographically dispersed or multi-site provider networks.

Multidisciplinary Leadership: Proven track record of guiding multidisciplinary teams and collaborating successfully with nursing and operational executives.

Location and Work Type

Work Setting: 100% Remote (Must reside within an approved state).

Approved Work States: AK, AR, AZ, CO, DC, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NC, ND, NE, NM, NV, OK, OR, SC, SD, TND, TX, UT, VA, WA, WI, WY.

Schedule: Structured 40-hour work week

Hourly Pay Rate: $140.00 – $145.00 per hour.

Perks: This high-priority "hot" search moves incredibly fast, offering rapid interview turnarounds, substantial career progression pathways, and the unique flexibility to retain your active clinical practice while stepping into elite executive leadership.