Medical Director, Utilization & Care Optimization

Altais; California (MO); Hybrid; USD 186,000 - 223,000; Full time

Benefits offered by this job

Medical, Vision, Dental

401k with company match

Paid holidays

Bonus program

Flexible time off

Job summary

Altais is seeking an experienced Utilization Management, Medical Director to provide clinical leadership across our California network. You will advance evidence-based care, monitor utilization, and partner with providers, care management, and operations to improve outcomes and resource stewardship.

You will lead quality improvement initiatives, oversee medical necessity reviews, support population health, and participate in UM committee activities.

Qualifications

• MD or DO degree with active, unrestricted license and board certification.
• Minimum 5 years clinical experience with at least 3 years in leadership.
• Strong understanding of quality improvement, healthcare regulations, and value-based care.

Responsibilities

• Provide clinical leadership for utilization management and care coordination.
• Lead quality improvement initiatives and evidence-based practices.
• Oversee medical necessity reviews and payer interactions.
• Partner with Quality, Care Management, and Population Health teams.
• Prepare and participate in UM committee meetings and strategic planning.
• Support provider recruitment, retention, and network development.

Skills

Leadership

Quality improvement

Communication

Data analysis

Utilization management

Population health

Provider relations

Education

MD or DO

Board certification

Medical license

Job description

Altais is seeking an experienced Utilization Management, Medical Director to provide clinical leadership across our California network. You will advance evidence-based care, monitor utilization, and partner with providers, care management, and operations to improve outcomes and resource stewardship.

You will lead quality improvement initiatives, oversee medical necessity reviews, support population health, and participate in UM committee activities.