Medical Director, Utilization Management — Lead Value Care

L.A. Care Health Plan; Los Angeles (CA); On-site; USD 206,311 - 350,729; Full time

Benefits offered by this job

Paid Time Off (PTO)

Tuition Reimbursement

Retirement Plans

Medical, Dental and Vision

Wellness Program

Job summary

A major health organization in Los Angeles is seeking a Medical Director for Utilization Management. This role requires significant clinical oversight, leadership experience, and collaboration across teams to ensure quality care and compliance. Candidates must hold an M.D. with 8+ years of relevant experience, particularly in medical management. The position offers comprehensive benefits including paid time off, tuition reimbursement, and retirement plans.

Qualifications

• 8+ years of experience in medical management and quality management.
• Experience in Payment Integrity and clinical practice.
• Strong analytic ability and leadership experience.

Responsibilities

• Provide clinical oversight for authorization decisions.
• Lead efforts in utilization management and payment integrity.
• Collaborate with teams to improve clinical outcomes.

Skills

Leadership

Communication Skills

Analytical Skills

Teamwork

Problem-solving

Education

Doctor of Medicine (M.D.)

Job description

A major health organization in Los Angeles is seeking a Medical Director for Utilization Management. This role requires significant clinical oversight, leadership experience, and collaboration across teams to ensure quality care and compliance. Candidates must hold an M.D. with 8+ years of relevant experience, particularly in medical management. The position offers comprehensive benefits including paid time off, tuition reimbursement, and retirement plans.