Primary Care Medical Director – Insurance Credentialed Physician Required

Overview

We are seeking a dynamic and experienced Medical Director to lead our clinical operations and uphold the highest standards of patient care, medical management, and healthcare quality. This pivotal role involves overseeing clinical protocols, ensuring compliance with regulatory standards, and fostering a culture of excellence within our healthcare organization. The ideal candidate will bring a passion for medical leadership, extensive healthcare management experience, and a commitment to advancing clinical development initiatives. Join us to shape innovative healthcare solutions and drive impactful patient outcomes in a fast-paced, collaborative environment.

During the initial onboarding and expansion phase, the Medical Director’s existing credentialed entity, payer enrollments, and associated billing infrastructure may be utilized, where legally permissible, for transitional billing operations until organizational credentialing and payer contracting are fully established.

Duties

• Provide strategic leadership for clinical programs, ensuring alignment with organizational goals and regulatory requirements such as HIPAA, FDA regulations, NCQA standards, and healthcare management best practices
• Oversee the development, implementation, and evaluation of clinical policies and procedures to ensure quality patient care and operational efficiency
• Supervise medical staff, including physicians, nurses, and allied health professionals, fostering a culture of continuous improvement and professional growth
• Collaborate with multidisciplinary teams to optimize utilization management, medical records accuracy, and EHR (Electronic Health Record) systems integration
• Lead clinical research initiatives to support evidence-based practices and innovative treatment approaches
• Ensure compliance with all legal and ethical standards related to patient care, medical terminology accuracy, physiology, and anatomy knowledge
• Manage budgets related to medical services, equipment procurement, and staffing to ensure financial sustainability while maintaining high-quality care
• Facilitate training on HIPAA compliance, medical records management, and relevant healthcare regulations for staff members
• Provide medical oversight and authorization for services billed under the Medical Director’s currently credentialed entity, tax ID, and payer enrollments until organizational credentialing and payer contracting are completed
• Support continuity of patient care and reimbursement operations during the credentialing transition period
• Collaborate with administrative and billing teams to ensure compliant billing practices in accordance with payer guidelines, state regulations, and federal healthcare requirements
• Assist with payer enrollment processes, credentialing documentation, and transitional operational oversight as needed
• Maintain compliance with all applicable laws, regulations, and documentation standards related to supervision requirements, medical necessity, and billing compliance

Experience

• Proven experience in healthcare management or medical leadership roles within hospital or clinic settings
• Extensive knowledge of managed care systems, utilization management processes, and EMR/EHR systems integration
• Demonstrated expertise in clinical research methodologies and clinical development processes
• Strong understanding of FDA regulations governing medical devices and pharmaceuticals as they relate to patient safety
• Supervising experience with multidisciplinary teams in fast-paced environments; excellent leadership skills with the ability to motivate staff
• Familiarity with NCQA standards for healthcare quality accreditation and continuous improvement initiatives
• Background in budgeting, resource allocation, and financial planning within healthcare organizations
• Deep knowledge of medical terminology, physiology, anatomy, and patient care protocols to guide clinical decision-making effectively

Join us as we lead the future of healthcare by delivering compassionate, patient-centered services driven by innovation and excellence. Your expertise will help shape policies that improve health outcomes while fostering a supportive environment for our dedicated medical teams.

Job Types: Full-time, Contract

Pay: From $650.00 per month

Work Location: Remote