Vice President, Health Services Medical Management

AltaMed; Commerce (CA); On-site; USD 316,000 - 396,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

403(b) retirement plan

Job summary

AltaMed seeks a Vice President of Medical Management to provide executive leadership and strategic oversight of Utilization Management, Care Management, and related clinical programs. The role drives high-quality, cost-effective, evidence-based care while ensuring regulatory and contractual compliance.

Collaboration with senior clinical leaders shapes population health and value-based-care initiatives. The position requires MD/DO with CA license, extensive leadership in managed care, and

Qualifications

• MD or DO from an accredited institution is required.
• Current unrestricted California physician license required.
• Current unrestricted DEA registration required.
• Board Certification in an ABMS- or AOA-recognized specialty required.
• Minimum of 10 years of progressive physician leadership in managed care, integrated delivery systems, or health plans.
• Minimum of 7 years leading Medical Management, Utilization Management, Population Health, or related clinical operations.
• Experience leading multidisciplinary teams and with value-based care and regulatory compliance.
• Familiarity with Medi-Cal, Medicare Advantage, NCQA, DMHC, CMS, and DHCS preferred.

Responsibilities

• Provide executive leadership for medical management functions including UM and CM.
• Develop enterprise strategies for high-quality, cost-effective, evidence-based care.
• Ensure compliance with regulatory and contractual requirements.
• Collaborate with executive and clinical leadership to drive performance and population health initiatives.

Skills

Executive leadership

Strategic direction

Regulatory compliance

Population health

Value-based care

Education

MD or DO

Job description

Grow Healthy

If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn't just welcomed - it's nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don't just serve our communities; we are an integral part of them. By raising the expectations of what a community clinic can deliver, we demonstrate our belief that quality care is for everyone. Our commitment to providing exceptional care, despite any challenges, goes beyond just a job; it's a calling that drives us forward every day.

Job Overview

The Vice President, Medical Management, provides executive leadership, strategic direction, and operational oversight for AltaMed's Medical Management functions, including Utilization Management (UM), Care/Complex Case Management (CM), and related clinical management programs. The VP develops and executes enterprise strategies that promote high-quality, cost-effective, evidence-based care while ensuring compliance with regulatory, accreditation, health plan, and contractual requirements. The VP works collaboratively with executive and clinical leadership to drive performance improvement, population health initiatives, value-based care strategies, and clinical integration across the organization. The VP provides leadership through multiple levels of management and senior clinical professionals and serves as a key advisor to executive leadership on medical management strategy.

Minimum Requirements

• Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) from an accredited institution is required.
• Current unrestricted California physician license required.
• Current unrestricted DEA registration required.
• Board Certification in an ABMS- or AOA-recognized specialty required.
• Minimum of 10 years of progressive physician leadership experience in managed care, integrated delivery systems, or health plans.
• Minimum of 7 years leading Medical Management, Utilization Management, Care Management, Population Health, or related clinical operations.
• Experience leading multidisciplinary teams through multiple layers of management.
• Experience with delegated managed care, value-based care, quality improvement, utilization review, and regulatory compliance.
• Experience with Medi-Cal, Medicare Advantage, NCQA, DMHC, CMS, and DHCS requirements strongly preferred.
• Federally Qualified Health Center (FQHC) or integrated delivery system experience preferred.

Compensation

$316,426.24 - $395,532.80 annually

Actual salary offers are considered by various factors, including budget, experience, skills, licensure and certifications, and other business considerations. The range is subject to change. AltaMed is committed to ensuring a fair and competitive compensation package that reflects the candidate's value and the role's strategic importance within the organization. This role may also qualify for discretionary bonuses or incentives.

Benefits & Career Development

• Medical, Dental and Vision insurance
• 403(b) Retirement savings plans with employer matching contributions
• Flexible Spending Accounts
• Commuter Flexible Spending
• Career Advancement & Development opportunities
• Paid Time Off & Holidays
• Paid CME Days
• Malpractice insurance and tail coverage
• Tuition Reimbursement Program
• Corporate Employee Discounts
• Employee Referral Bonus Program
• Pet Care Insurance

Job Advertisement & Application Compliance Statement

AltaMed Health Services Corp. will consider qualified applicants with criminal history pursuant to the California Fair Chance Act and City of Los Angeles Fair Chance Ordinance for Employers. You do not need to disclose your criminal history or participate in a background check until a conditional job offer is made to you. After making a conditional offer and running a background check, if AltaMed Health Service Corp. is concerned about a conviction directly related to the job, you will be given a chance to explain the circumstances surrounding the conviction, provide mitigating evidence, or challenge the accuracy of the background report.