Medical Director Physician

SHR (Spectrum Healthcare Resources); Nevada; Remote; USD 210,000 - 320,000; Full time

Job summary

Spectrum Healthcare Resources seeks a Behavioral Health Medical Director for a remote, civilian role supporting TriCare/DoD and Community Care Network/VA programs.

You will lead clinical quality initiatives, guide utilization and case management, and collaborate with TriWest teams to improve population health and outcomes. Requires MD/DO, board certification, DoD background, and 5+ years’ practice in managed care.

Qualifications

• MD or DO from an accredited medical school.
• Active, unrestricted license to practice medicine in the United States.
• Board certification or board eligibility through a recognized specialty board.
• U.S. Citizenship.
• Favorable background investigation through the DoD.
• Minimum of 5 years of medical practice experience.
• 3+ years of experience in managed care environments.
• Preferred: Experience with TRICARE, Veterans Affairs, or other federal health plans.
• Advanced degree in management (MPA, MBA, MHA, MPH).
• Corporate-level leadership experience.
• Experience using InterQual and/or similar evidence-based criteria to assess medical interventions.

Responsibilities

• Provide program-wide clinical guidance across medical management domains including Utilization Management, Case Management, Quality, and Public Health.
• Lead and participate in quality committees and collaborative safety initiatives.
• Review member cases for appropriateness and quality of care; document findings in CareRadius and other health systems.
• Conduct peer-to-peer discussions with network providers and internal stakeholders.
• Develop and implement corrective action plans related to clinical quality or provider performance.
• Collaborate with TriWest teams such as Clinical Operations, Data Analytics, and General Counsel.
• Provide clinical expertise on new technologies, treatment protocols, and population health initiatives.
• Interact with veterans and beneficiaries to support satisfaction and outcomes.
• Stay current with licensure, board certification, and federal medical standards.

Skills

Leadership

Quality improvement

Clinical governance

Education

MD/DO degree

Board certification/eligibility

Advanced management degree

Tools

InterQual

Job description

Spectrum Healthcare Resources is excited to offer a potential career opportunity for a Behavioral Health Medical Director supporting the TriCare/Department of Defense and Community Care Network/Department of Veterans Affairs. This remote-based civilian position is an outstanding chance to make a meaningful contribution to the healthcare of veterans and military beneficiaries while benefiting from work-life flexibility, professional collaboration, and impactful leadership. Join us in leading high-quality care initiatives for those who have served our country, with a focus on system-wide clinical improvement, peer collaboration, and mission-driven support!

Requirements:

• Doctor of Medicine (MD) or Doctor of Osteopathy (DO) from an accredited medical school.
• Active, unrestricted license to practice medicine in the United States.
• Board certification or board eligibility through a recognized specialty board.
• U.S. Citizenship.
• Favorable background investigation through the Department of Defense (DoD).
• Minimum of 5 years of medical practice experience.
• 3+ years of experience in managed care environments.
• Preferred:Experience working with TRICARE, Veterans Affairs, or other federal health plans.
• Advanced degree in management (MPA, MBA, MHA, MPH).
• Corporate-level leadership experience.
• Experience using InterQual and/or similar evidence-based criterial to assess medical interventions, procedures and treatments.

Job Responsibilities:

• Provide program-wide clinical guidance across multiple medical management domains including Utilization Management, Case Management, Quality, and Public Health.
• Lead and participate in quality committees and collaborative safety initiatives.
• Review member cases for appropriateness and quality of care; document findings in CareRadius and other health systems.
• Conduct peer-to-peer discussions with network providers and internal stakeholders.
• Develop and implement corrective action plans related to clinical quality or provider performance.
• Collaborate closely with TriWest teams such as Clinical Operations, Data Analytics, and General Counsel.
• Provide clinical expertise on new technologies, treatment protocols, and population health initiatives.
• Interact with veterans and beneficiaries to support satisfaction and outcomes.
• Stay current with required licensure, board certification, and federal medical standards.

Working Conditions:

• Remote position with standard weekday hours and occasional after-hours availability.
• Extensive computer-based work; prolonged periods of sitting may be necessary.

Company Overview:

Spectrum Healthcare Resources (SHR) was established in 1988 to deliver systems and processes designed to meet the unique needs of Military and VA Health Systems. SHR is a leading organization that provides physician and clinical staffing and management services to United States Military Treatment Facilities, VA clinics and other Federal Agencies through various contracting vehicles. A Joint Commission Health Care Staffing Services firm, SHR is the military staffing division of TeamHealth, a Nationwide organization that serves 850 civilian and military hospitals with a team of 9,600 affiliated health care professionals.

EOE/Disabled/Veterans