Value-Based Medical Director — Lead Care & Policy

Prominence Health; McAllen (TX); On-site; USD 200,000 - 280,000; Full time

Benefits offered by this job

Loan forgiveness

Competitive pay & PTO

Health benefits (medical/dental/vision

401(k) with company match

Student loan refinancing

Career development

Job summary

Prominence Health is seeking a Medical Director to lead the Health Services Department, overseeing Utilization Management, Care Management, Disease Management, Quality Improvement, Pharmacy Management, Risk Adjustment and Community Provider Relations. The role requires active medical licensure in applicable states and board-certified expertise.

The Medical Director will shape policy, participate in cross-functional teams, and may travel to PHP markets to support growth and member outcomes.

Qualifications

• MD with board certification preferred.
• Current license in U.S. state(s) allowing medical practice.
• Minimum five years of direct patient care experience.

Responsibilities

• Direct the Health Services Department goals and objectives.
• Provide leadership for Utilization, Care, Disease, Pharmacy Management and Quality Improvement.
• Collaborate with cross-functional teams and participate in multi-disciplinary groups.

Skills

Medical leadership

Utilization management

Care management

Quality improvement

Provider relations

Strategic direction

Education

Doctorate of Medicine

MBA / MHA preferred

Job description

Prominence Health is seeking a Medical Director to lead the Health Services Department, overseeing Utilization Management, Care Management, Disease Management, Quality Improvement, Pharmacy Management, Risk Adjustment and Community Provider Relations. The role requires active medical licensure in applicable states and board-certified expertise.

The Medical Director will shape policy, participate in cross-functional teams, and may travel to PHP markets to support growth and member outcomes.