Regional Medical Director: Value-Based Care Leader

E2E Alignment Healthcare USA, LLC; California (MO); Hybrid; USD 262,000 - 393,000; Full time

Job summary

Alignment Health is seeking a Regional Medical Director to lead clinical, quality, utilization, risk adjustment, and financial performance across assigned markets for provider networks. You will collaborate with Network Management, pharmacies, care management, and internal teams to drive Stars and population health improvements, while serving as a trusted advisor to providers and health systems.

The role is hybrid, requiring on-site provider engagement and remote management across markets.

Qualifications

• Minimum 5 years of clinical practice experience.
• Minimum 3–5 years of leadership experience within managed care, Medicare Advantage, physician organizations, IPA/MSO, or value-based care environments.

Responsibilities

• Serve as the physician leader supporting performance across assigned markets and provider networks.
• Maintain a deep understanding of local provider landscapes, referral patterns, market dynamics, and local operational challenges impacting performance within their region.
• Build collaborative relationships with providers to promote alignment around managed care principles, population health strategies, quality improvement initiatives, and value-based care performance.
• Partner with Network Management and network providers to improve quality, affordability, risk adjustment, Stars, member experience, and overall value-based care performance.
• Lead provider-facing discussions, performance reviews, and action planning efforts to drive accountability and measurable outcomes.
• Act as a trusted clinical advisor to provider groups, IPAs, health systems, and internal stakeholders.
• Analyze clinical, operational, financial, utilization, and quality data to identify performance gaps and improvement opportunities.
• Develop and support market-specific strategies that improve MLR, utilization, quality outcomes, care coordination, and population health performance.
• Collaborate with providers and provider organizations to implement evidence-based interventions that improve efficiency, consistency of care, and member outcomes.
• Monitor performance against established goals and adjust strategies as needed to achieve sustainable results.
• Partner with provider organizations and internal teams to improve documentation accuracy, risk adjustment performance, chronic disease management, and preventive care outcomes.
• Support provider engagement efforts focused on improving Stars, HEDIS, CAHPS, HOS, medication adherence, and care gap closure.
• Promote population health strategies that improve member outcomes while supporting organizational objectives.
• Collaborate with Network Management, Risk Adjustment, Quality, Pharmacy, Care Management, Utilization Management, Analytics, and Operations teams to align improvement strategies and execution efforts.
• Support value-based care initiatives, provider performance programs, and other enterprise priorities.
• Participate in market, provider, and organizational committees, workgroups, and strategic initiatives as assigned.
• Maintain knowledge of Medicare Advantage, CMS, and applicable regulatory requirements impacting provider performance, quality, medical management, and population health.
• Serve as a visible physician leader within the market, fostering strong provider relationships and supporting Alignment's value-based care strategy.
• Other duties as assigned.

Skills

Clinical leadership

Provider engagement

Data analysis

Utilization management

Communication

Education

MD/DO degree

Board certification in ABMS or AOA specialty

Active medical license

Job description

Alignment Health is seeking a Regional Medical Director to lead clinical, quality, utilization, risk adjustment, and financial performance across assigned markets for provider networks. You will collaborate with Network Management, pharmacies, care management, and internal teams to drive Stars and population health improvements, while serving as a trusted advisor to providers and health systems.

The role is hybrid, requiring on-site provider engagement and remote management across markets.