Remote Medical Director, Utilization & Care Innovation

Altais; California (MO); Hybrid; USD 223,000 - 267,000; Full time

Benefits offered by this job

Medical, vision, and dental coverage

401(k) with company match

Flexible time off + 9 paid holidays

Annual bonus program

Job summary

Altais is seeking a Medical Director of Utilization and Medical Management to drive Utilization Management policy and lead interdisciplinary teams in California. You will co-chair committees, collaborate with physician leaders, and ensure high-quality, cost-conscious patient care within a dynamic network.

The role requires a California MD license, board certification, and 12+ years in managed care settings, with a base salary of $222,750–$267,300/year plus a full benefits package.

Qualifications

• MD with California license and board certification.
• 12+ years as practicing inpatient/outpatient physician in a managed care environment.
• Experience leading Utilization Management committees and interfacing with health plans.

Responsibilities

• Develop and implement Utilization Management policies and procedures.
• Co-chair or lead committees such as UM Committee, Quality Management Committee, and Peer Review/Patient Safety Committee.
• Collaborate with physician leaders and health plans to ensure cost containment without compromising outcomes.
• Educate PCPs and specialists on utilization management systems and criteria.
• Coordinate prospective, concurrent, and retrospective reviews of external referrals and develop standard care protocols.

Skills

Leadership

Utilization management

Quality management

Interdisciplinary collaboration

Policy development

Education

Doctor of Medicine (MD) degree

California medical license

Board certification

Job description

Altais is seeking a Medical Director of Utilization and Medical Management to drive Utilization Management policy and lead interdisciplinary teams in California. You will co-chair committees, collaborate with physician leaders, and ensure high-quality, cost-conscious patient care within a dynamic network.

The role requires a California MD license, board certification, and 12+ years in managed care settings, with a base salary of $222,750–$267,300/year plus a full benefits package.