medical director

Putting things into Perspective LLC

<p>Reports To: Chief Executive Officer / Executive Director</p><p>Employment Type: Full-Time</p><p>Position Summary</p><p>The Medical Director provides overall medical, clinical, and quality oversight for the Critical Access Behavioral Health Agency (CABHA). This role ensures the delivery of high-quality, medically necessary behavioral health services in compliance with all applicable federal and state laws, including North Carolina Medicaid (DMA) regulations, accreditation standards, and CABHA requirements.</p><p>Minimum Qualifications</p><p>The Medical Director must:</p><ul><li>Be enrolled as a provider and in good standing with the North Carolina Division of Medical Assistance (DMA)</li><li>Meet one of the following criteria:</li><li>Board-certified or board-eligible psychiatrist (MD or DO) through the American Board of Psychiatry and Neurology, licensed in North Carolina; OR</li><li>A North Carolina licensed physician with ASAM or ABAM certification (for substance abuse-only services); OR</li><li>A North Carolina licensed physician approved through the DMA exception process, with board certification/eligibility in:</li><li>Family Medicine</li><li>Internal Medicine</li><li>Pediatrics</li><li>Have a minimum of two (2) years post-residency experience:</li><li>Diagnosing, treating, and evaluating behavioral health conditions</li><li>Providing face-to-face clinical care to individuals with mental health and/or substance use disorders</li><li>Experience must reflect direct service delivery (not limited to medical necessity reviews)</li></ul><p>FTE Requirements (Based on CABHA Size)</p><ul><li>750+ consumers: 100% FTE (may be shared by up to 2 physicians)</li><li>376&ndash;749 consumers: Minimum 50% FTE</li><li>&le;375 consumers: Minimum 20% FTE</li></ul><p>FTE limitations and billable service hours must comply with CABHA regulations.</p><p>Key Responsibilities</p><p>Clinical Leadership &amp; Oversight</p><ul><li>Provide direct oversight of all medical, clinical, and quality management functions</li><li>Ensure compliance with:</li><li>North Carolina Medicaid policies</li><li>CABHA regulations</li><li>Accreditation standards</li><li>Applicable federal and state laws</li><li>Lead practice improvement and quality assurance initiatives</li></ul><p>Policy Development &amp; Compliance</p><ul><li>Develop and implement policies for:</li><li>Consumer admission, reassessment, transfer, and discharge</li><li>Delivery of medically necessary and evidence-based services</li><li>Ensure compliance with:</li><li>North Carolina Medical Board regulations</li><li>American Psychiatric Association treatment guidelines</li><li>Telemedicine requirements (DMA Clinical Coverage Policy 1H)</li></ul><p>Clinical Supervision &amp; Staff Oversight</p><ul><li>Supervise and provide direction to:</li><li>Physicians</li><li>Nurse Practitioners</li><li>Physician Assistants</li><li>Clinical staff</li><li>Conduct:</li><li>Clinical case reviews</li><li>Peer reviews</li><li>Quality of care audits</li><li>Maintain a regular on-site or virtual presence using secure telehealth platforms</li></ul><p>Consumer Care &amp; Treatment Oversight</p><ul><li>Ensure completion of:</li><li>Comprehensive psychiatric evaluations</li><li>Clinical assessments</li><li>Level of care determinations</li><li>Participate in:</li><li>Treatment team meetings</li><li>High-risk and complex case reviews</li></ul><p>Incident Review &amp; Risk Management</p><ul><li>Review and respond to all critical incidents, including:</li><li>Medication errors or diversion</li><li>Allegations of abuse or neglect</li><li>Injuries to consumers or staff</li><li>Consumer deaths (within 120 days of service)</li><li>Ensure proper documentation, reporting, and corrective action</li></ul><p>Quality Management &amp; Data Oversight</p><ul><li>Serve on the Quality Management Committee</li><li>Monitor and evaluate:</li><li>Service access and engagement</li><li>Treatment effectiveness</li><li>Consumer outcomes and satisfaction</li><li>Utilization trends (including crisis and inpatient services)</li></ul><p>Additional Responsibilities</p><ul><li>Participate in leadership meetings and strategic planning</li><li>Ensure ethical medical decision-making aligned with professional standards</li><li>Perform other duties as assigned within scope of practice</li></ul><p>Work Environment &amp; Expectations</p><ul><li>Combination of administrative and clinical responsibilities</li><li>May include telehealth and in-person services</li><li>Must maintain documentation and reporting compliance</li></ul><p>Pay: $50,128.36 - $60,000.00 per year</p><p>Work Location: In person</p>

Medical Director

Pelican Ambulance, LLC

<p><b>Overview</b><br/>We are seeking a dynamic and highly experienced Medical Director to lead our clinical operations and ensure the delivery of exceptional patient care. This pivotal role combines strategic leadership with hands-on management of clinical teams, compliance, and healthcare standards. The Medical Director will oversee medical practices, foster innovative clinical development, and uphold regulatory compliance to promote excellence across all healthcare services. This is an exciting opportunity for a passionate medical professional eager to influence healthcare quality and operational efficiency on a broad scale.</p><p><b>Duties</b></p><ul><li>Provide visionary leadership in clinical management, guiding physicians, nurses, and healthcare staff to deliver patient-centered care aligned with organizational goals.</li><li>Develop, implement, and monitor clinical policies adhering to healthcare regulations such as HIPAA, FDA regulations, NCQA standards, and hospital accreditation requirements.</li><li>Oversee the utilization management process to optimize patient outcomes while maintaining cost-effective care through managed care strategies.</li><li>Collaborate with research teams to facilitate clinical research initiatives, ensuring compliance with ethical standards and regulatory guidelines.</li><li>Manage electronic health record (EHR) systems and medical records to ensure accuracy, confidentiality, and accessibility for authorized personnel.</li><li>Lead quality improvement programs by analyzing clinical data, patient feedback, and performance metrics to enhance service delivery.</li><li>Supervise medical staff recruitment, training, performance evaluations, and ongoing professional development to maintain high standards of patient care.</li><li>Coordinate with hospital administration on budgeting, resource allocation, and strategic planning to support sustainable growth and innovation.</li></ul><p><b>Requirements</b></p><ul><li>Medical degree (MD or DO) from an accredited institution with active licensure in relevant jurisdictions.</li><li>Extensive experience in hospital or healthcare management with proven leadership in a senior medical role.</li><li>Deep knowledge of physiology, anatomy, medical terminology, and clinical development processes.</li><li>Familiarity with EMR (Electronic Medical Records) systems and EHR (Electronic Health Records) systems for documentation and data analysis.</li><li>Strong understanding of managed care principles, utilization management protocols, HIPAA compliance, and NCQA standards.</li><li>Experience conducting or overseeing clinical research projects with adherence to FDA regulations.</li><li>Excellent project management skills with the ability to oversee multiple initiatives simultaneously.</li><li>Supervisory experience managing multidisciplinary teams within a healthcare setting.</li><li>Ability to interpret medical records accurately and apply findings to improve patient care strategies.</li><li>Demonstrated leadership qualities with a focus on innovation, collaboration, and continuous improvement. Join us as a Medical Director where your expertise will shape the future of healthcare delivery! We are committed to fostering an inclusive environment that values your leadership skills and dedication to excellence in patient care.</li></ul><p>Pay: $1,300.00 per month</p><p>Work Location: Remote</p>

Sanitas Medical Center

<div><p>Job Summary</p><p>
The Medical Director is responsible for the coordination and oversight of all medical care and quality of services provided at the center level. They ensure proper functioning of day&ndash;to-day operations of the facility, in coordination with clinic staff, to provide consistent quality of care to patients. This role also provides delivery of medical services to patients of the center. The Medical Director oversees the activities of group providers, analyzes results and provides feedback.</p><p>
Essential Job Functions</p><p><i>
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.</i></p><ul><li>
Provides leadership for several activities related to the delivery of medical care and clinical services such as cost management, utilization review and quality assurance.</li><li>
Collaborates in the development and periodic review of written clinical policies, guidelines and protocols for the functioning of the clinic and responsibilities of the clinicians.
</li><li>Supervises risk coding, HEDIS quality metric completion by group providers and provides feedback.</li><li>
Participates in the recruitment and selection process for medical providers and other clinic staff.</li><li>
Plans, assigns, and directs work; assesses and appraises providers performance.</li><li>
Assumes responsibility for quality of medical services rendered to patients by monitoring quality and appropriateness of care.</li><li>
Provides guidance and leadership for performance guidelines.</li><li>
Oversee clinical peer review.</li><li>
Provides supervision of continuing professional education, in-service training and orientation of new medical staff.</li><li>
Provides key input to the development of care delivery policies and procedures.</li><li>
Oversees documentation and care planning.</li><li>
Performs periodic review of practice management functions.</li><li>
Address emergency issues.</li><li>
Assures a high standard of medical care by reviewing results of patient satisfaction surveys; reviews and handles clinical patient complaints.
</li><li>Maintains OSHA, ACHA, emergency preparedness, infection control and regulatory compliance for the clinic.</li><li>
Supports provider education, in-service training and orientation of new medical staff.</li><li>
Provides professional oversight for advanced practice nurses (ARNP) and/or physician assistants (PAs) with collaboration agreements.</li><li>
Handles provider behavior and impairment issues.
</li><li>Analyzes, manages and develops improvement plans for adverse events as well as patient complaints/issues that arise from medical care.</li><li>
Leads physician governance committees to include Medical Records Quality Committee, Infection Diseases Committee, and Adverse Events Committee.
</li><li>Participate and lead in future development projects for the organization.</li><li>
Deliver direct patient care within the clinic scope of practice.</li><li>
Perform other duties as assigned by the executive team.</li></ul><p>
Supervisory Responsibilities</p><p>
This position manages all employees of the department and is responsible for the performance management and hiring of the employees within that department.</p><p>
Required Education</p><ul><li>
MD or DO degree from an accredited school of medicine.</li></ul><p>
Required Experience</p><ul><li>
At least 2 years of experience as a primary care physician and 1 year as a Medical Director.</li><li>
At least 2 years of experience working with a multicultural patient population delivering patient-centric programs that are high quality and cost effective.</li></ul><p>
</p><p>Required Licenses and Certifications</p><ul><li>
Unrestricted license to practice medicine in the selected state.</li><li>
Board certified in one of the primary care specialties.</li></ul><p>
Required Knowledge, Skills, and Abilities</p><ul><li>
Any combination of education, training, and experience which demonstrates the ability to perform the duties and responsibilities as described including related work experience.</li></ul><p>
Preferred Qualifications</p><ul><li>
N/A</li></ul><p>
Financial Responsibilities</p><p>
This position does not currently have financial responsibilities.</p><p>
Budget Responsibilities</p><p>
This position does not currently have budget responsibilities.</p><p>
</p><p>Languages</p><ul><li>
Advanced English is required.</li><li>
Spanish is preferred.</li></ul><p>
Travel</p><p>
Required: Flexible to travel per business needs.</p><p>
Physical Demands and Work Environment</p><p><i>
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
</i></p><ul><li>Prolonged periods working at a computer and participating in meetings.</li><li>
Ability to travel periodically to clinics, market sites, and corporate meetings as required.</li><li>
May occasionally spend time on-site in clinical or operational settings; exposure to healthcare environments (noise, temperature variation, patient interaction) is possible.</li><li>
Comfort managing in a fast-paced, multi-site healthcare organization.</li><li>
Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.</li></ul><p>
</p><p>Environmental Conditions</p><p>
Inside: The employee is subject to environmental conditions, protection from weather conditions but not necessarily from temperature changes. The worker is subject to noise; there may be sufficient noise to cause the worker to shout in order to be heard above ambient noise level.<br>
</p><p>Physical/Environmental Activities</p><p><i>
Please confirm for the following questions if these working conditions are encountered Occasionally (1-33% of time on the job), Frequently (34-66% of time on the job), Constantly (67-100% of time on the job), or Not Applicable N/A</i></p><p>
Must be able to travel to multiple locations for work (i.e. travel to attend meetings, events, conferences). Frequency: Occasionally (1-33%)</p><p>
May be exposed to outdoor weather conditions of cold, heat, wet, and humidity. Frequency: N/A</p><p>
May be exposed to outdoor or warehouse conditions of loud noises, vibration, fumes, dust, odors, and mists. Frequency: N/A</p><p>
Must be able to ascend and descend ladders, stairs, or other equipment. Frequency: N/A<br>
Subject to exposure to hazardous material. Frequency: Occasionally (1-33%)</p></div>

State of Illinois

<div><div><b>Job Requisition ID: </b>53836</div><div><b>
Opening</b><b> Date:</b> 03/20/2026<br>
<b>Closing Date:</b> 04/16/2026<br>
<b>Agency: </b>Department of Human Services<br>
<b>Class Title:</b> MEDICAL ADM II OPT D - 26403<br>
<b>Skill Option: </b>Special License - IL License to Practice Medicine - Internal Medicine<br>
<b>Bilingual Option: </b>None<br>
<b>Salary:</b> Anticipated Salary: $24,353 - $26,353 per month ($292,236 - $316,236 per year)<br>
<b>Job Type:</b> Salaried<br>
<b>Category:</b> Full Time<br>
<b>County:</b> Lee<br>
<b>Number of Vacancies:</b> 1<br>
<b>Bargaining Unit Code: </b>None<br>
<b>Merit Comp Code:</b> Term Appointment/ Agency</div><div></div><div><br>
A resume is highly encouraged to evaluate your qualifications and skills as part of your application. Please attach a <b>DETAILED</b><b> Resume/Curriculum Vitae (CV)</b> to the <b>MY DOCUMENTS</b> section of your application if you decide to provide one.</div><div></div><div><br>
When applicable, titles that require specific coursework, professional license or certification will include a notation requesting the appropriate document(s) be uploaded in the Additional Documents section of your application. Failure to upload requested transcripts, license and/or proof of certification when specified may result in ineligibility. Please note that the Department of Human Services must verify proof of higher education for any degree earned (if applicable) regardless of vacancy title before any offer can be extended.</div><div></div><h1 class="jobSectionHeader"><b><br>
Why Work for Illinois?</b></h1><div></div><div><br>
Working with the State of Illinois is a testament to the values of compassion, equity, and dedication that define our state. Whether you&rsquo;re helping to improve schools, protect our natural resources, or support families in need, you&rsquo;re part of something bigger&mdash;something that touches the lives of every person who calls Illinois home.</div><div></div><div><br>
No matter what state career you&rsquo;re looking for, we offer jobs that fit your life and your schedule&mdash;flexible jobs that provide the gold standard of benefits. Our employees can take advantage of various avenues to advance their careers and realize their dreams. Our top-tier benefits and great retirement packages can help you build a rewarding career and lasting future with the State of Illinois.</div><div><div><div><h2 class="jobSectionHeader"><b>
Position Overview
</b></h2></div><div><p>The Division of Developmental Disabilities is seeking to hire an Illinois licensed Internal Medicine medical professional to provide medical leadership and oversight of the medical services provided at the Mabley Development Center in Dixon. The Mabley Developmental Center serves a broad spectrum of individuals with behavioral and medical needs.
</p></div></div><div><div><h2 class="jobSectionHeader"><b>Essential Functions
</b></h2></div><div><ul><li>Serves as the Medical Director for the Mabley Developmental Center.
</li><li>Serves as full-line supervisor.
</li><li>Monitors and evaluates the delivery of medical, dental, and rehabilitation services.
</li><li>Serves as a consultant to staff physicians.
</li><li>Provides technical medical training and assistance to internal and external stakeholders.
</li><li>Serves as member of the Facility&rsquo;s Executive Committee and other facility standing and ad hoc committees.
</li><li>Performs other duties as required or assigned which are reasonably within the scope of the duties enumerated above.</li></ul></div></div><div><div><h2 class="jobSectionHeader"><b>
Minimum Qualifications
</b></h2></div><div><ul><li>Requires an Illinois license to practice medicine and an American Board of Medical Specialties certification or its equivalent in the medical specialty of Internal Medicine.</li><li>
Requires three (3) years substantive medical administrative experience in directing, planning and evaluating a medical/clinical program.</li></ul></div></div><div><div><h2 class="jobSectionHeader"><b>
Preferred Qualifications
</b></h2></div><div><ul><li>Three (3) years of professional experience working with professional health services, disciplines and program support functions which must be coordinated in administering a comprehensive medical health program.</li><li>
Three (3) years of professional experience managing and evaluating the delivery of medical care, treatment and services.</li><li>
Three (3) years of professional experience as a physician working with concepts and practices in internal medicine.</li><li>
Three (3) years of professional experience recommending changes to medical service programs.</li><li>
Three (3) years of experience providing technical medical training and assistance to internal and/or external stakeholders.</li><li>
Three (3) years of professional experience communicating with both internal and/or external stakeholders daily on medical services.</li></ul></div></div><div><div><h2 class="jobSectionHeader"><b>
Conditions of Employment</b></h2></div><div><ul><li>
Requires ability to work after business hours, weekends and holidays on a rotation basis.
</li><li>Requires the ability to travel.
</li><li>Requires the ability to utilize office equipment, including personal computers.
</li><li>Requires ability to pass the IDHS background check.</li><li>
Requires ability to pass a drug screen for drugs prohibited from recreational use under Illinois Law.</li><li>The conditions of employment listed here are incorporated and related to any of the job duties as listed in the job description.</li></ul></div></div></div><p></p><div><b><br>
Work Hours: </b>Mon - Fri, 8:00am - 4:30pm; 1-hour unpaid lunch</div><div><b>
Headquarter Location: </b>1120 Washington Ave, Dixon, Illinois, 61021-1258</div><div>
Division of Developmental Disabilities</div><div>
Mabley Developmental Center</div><div>
Medical Services</div><div><b>
Work County: </b>Lee</div><div><b>
Agency Contact: </b>DHS.HiringUnit@illinois.gov</div><div><b>
Posting Group: </b>Health Services; Social Services</div><div></div><div><b><br>
About the Agency:</b></div><div>
The Illinois Department of Human Services uplifts individuals and communities across Illinois. Our mission is to respond to the needs of all people in Illinois so they can lead healthy, safe, and enriched lives. Our vision is the future we are shaping with dignity and the well-being for everyone in Illinois. Our values are the principles that guide us as we work to remove systemic barriers and create lasting opportunities with Compassion, Accessibility, Responsibility, and Equity.</div><div></div><div><br>
As a State of Illinois Employee, you will receive a robust benefit package that includes the following:</div><ul><li>
A Pension Program</li><li>
Competitive Group Insurance Benefits including Health, Life, Dental and Vision Insurance</li><li>
3 Paid Personal Business Days annually</li><li>
12 Paid Sick Days annually (Sick days carry over from year to year)</li><li>
10-25 Days of Paid Vacation time annually - (10 days in year one of employment)
</li><li><ul><li>Personal, Sick, &amp; Vacation rates modified for 12-hour &amp; part-time work schedules (as applicable)</li></ul></li><li>
13 Paid Holidays annually, 14 on even numbered years</li><li>
Flexible Work Schedules (when available dependent upon position)</li><li>
12 Weeks Paid Parental Leave</li><li>
Deferred Compensation Program - A supplemental retirement plan</li><li>
Optional Pre-Tax Programs such as Medical Care Assistance Plan (MCAP), Dependent Care Assistance Plan (DCAP)</li><li>
Federal Public Service Loan Forgiveness Program eligibility</li><li>
GI Bill&reg; Training/Apprenticeship Benefits eligibility for qualifying Veterans</li><li>
5% Salary Differential for Bilingual Positions</li><li>
Commuter Savings Program (Chicago only)</li></ul><div>
For more information about our benefits please follow this link: https://cms.illinois.gov/benefits/stateemployee.html</div><div></div><div><b><br>
Term Appointment:</b><br>
Candidates hired into a term position shall be appointed for a term of 4 years and are subject to a probationary period. The term may be renewed for successive four-year terms at the Director of the Department of Human Services&rsquo;s discretion.</div><div><br>
</div><div><b>APPLICATION INSTRUCTIONS</b></div><div>
Use the &ldquo;Apply&rdquo; button at the top right or bottom right of this posting to begin the application process.</div><div>
If you are not already signed in, you will be prompted to do so.</div><div>
State employees should sign in to the career portal for State of Illinois employees &ndash; a link is available at the top left of the Illinois.jobs2web.com homepage in the blue ribbon.</div><div>
Non-State employees should log in on the using the &ldquo;View Profile&rdquo; link in the top right of the Illinois.jobs2web.com homepage in the blue ribbon. If you have never before signed in, you will be prompted to create an account.</div><div>
If you have questions about how to apply, please see the following resources:</div><div>
State employees: Log in to the career portal for State employees and review the Internal Candidate Application Job Aid</div><div>
Non-State employees: on Illinois.jobs2web.com &ndash; click &ldquo;Application Procedures&rdquo; in the footer of every page of the website.</div><div>
State employees should include temporary assignment in the application profile. Temporary assignment verification forms can be uploaded to the Additional Documents section.</div><div></div><div><br>
The main form of communication will be through email. Please check your &ldquo;junk mail&rdquo;, &ldquo;spam&rdquo;, or &ldquo;other&rdquo; folder for communication(s) regarding any submitted application(s). You may receive emails from the following addresses:</div><ul><li>
donotreply@SIL-P1.ns2cloud.com</li><li>
systems@SIL-P1.ns2cloud.com</li></ul></div>

Fresh Clinics

<p><b>About the role</b></p><p>We are seeking a highly responsive Medical Director to join our team as a dedicated physician partner. Fresh acts as the bridge between independent aesthetic practitioners and the complex regulatory landscape. In this role, you will provide medical governance and oversight for <b>multiple practices within Georgia,</b> operating within state-specific regulatory limits.</p><p>This role is designed for a clinician who wants to move away from the &quot;absentee&quot; model and toward a &quot;gold standard&quot; of oversight that is reliable and deeply integrated into member safety. You will serve as the clinical safety net, providing the necessary authority for members to legally perform procedures and order professional-grade supplies.</p><p><b>What you'll do</b></p><p>This is a remote-first, high-execution role designed for a physician who can provide clinical agility across a diverse portfolio of medspas.</p><ul><li><b>Georgia Compliance:</b> Act as the primary physician of record for Georgia-based aesthetic practices, ensuring all delegation follows the specific Georgia Composite Medical Board rules.</li><li><b>Protocol Approval:</b> Approve and oversee clinical protocols for treatments including botulinum toxin, dermal fillers, IV therapy, and laser services.</li><li><b>Multi-Site Oversight:</b> Supervise and delegate medical procedures to qualified staff (RNs, NPs, aestheticians) across multiple locations in compliance with state laws.</li><li><b>Operational Partnership:</b> Support the Ops team by providing timely signatures and mandatory training certifications to get member supplier accounts active.</li><li><b>Chart Auditing:</b> Log into the EMR to review a randomized 10% of patient charts monthly to ensure documentation standards are met.</li><li><b>Adverse Event (AE) Management: </b>Leverage Fresh&rsquo;s centralized clinical team as the primary resource for complication management, and provide clinical support or guidance when needed, rather than acting as the sole complication manager.</li><li><b>Clinical Community:</b> Attend ongoing webinars and the monthly USA Doctors&rsquo; &ldquo;Morbidity and Most-Excellent-cases&rdquo; meeting.</li></ul><p><b>We'd love you to have</b></p><ul><li><b>GA Licensure:</b> Must hold an active, unrestricted <b>Georgia MD or DO license</b>.</li><li><b>Regional Proximity:</b> Current residency in <b>Atlanta or Savannah</b> is required to facilitate potential on-site emergency escalations or local regulatory audits.</li><li><b>Multi-State Licensure:</b> Holding additional licenses in &quot;High-Volume&quot; states (FL, TX, CA, NY) is a significant plus.</li><li><b>Aesthetic familiarity:</b> Openness to learning and pursuing education in aesthetic medicine, even if you do not have prior hands-on experience</li><li><b>Regulatory Knowledge:</b> Basic knowledge of state-specific laws regarding delegation and supervision (Fresh provides internal management of complex regulatory landscapes).</li><li><b>Remote Proficiency:</b> Experience using EMRs for chart auditing and the ability to manage digital signatures with 100% accuracy.</li><li><b>Board Certification:</b> MD or DO in good standing; specialties like Plastic Surgery, Dermatology, or Family Medicine are ideal.</li><li><b>Insurance:</b> Must carry malpractice insurance as required by state laws.</li></ul><p><b>Who you are</b></p><ul><li><b>A Senior Executor:</b> You value your time and appreciate a model that automates administrative headaches so you can provide oversight from your laptop.</li><li><b>A Clinical Professional:</b> You can quickly review a patient chart and identify if a safety risk exists.</li><li><b>Highly Responsive:</b> You understand that timely email and document sign-offs are critical to the success of our members and the Ops team.</li><li><b>Problem Solver:</b> You thrive in fast-paced environments and can manage the complexities of overseeing multiple providers across different time zones.</li></ul><p><b>Why Fresh</b></p><ul><li><b>Optimized Passive Income:</b> High hourly value for a low active-time commitment&mdash;the &quot;Holy Grail&quot; for physicians.</li><li><b>Portfolio Career:</b> Maintain your primary practice or retirement while staying relevant in the $15B+ aesthetics market.</li><li><b>Zero Overhead:</b> Fresh handles the sales, billing, and member management.</li></ul><p>Job Type: Contract</p><p>Pay: $51,317.63 - $61,801.88 per year</p><p>Work Location: Remote</p>

CVS Health

<div><p>We&rsquo;re building a world of health around every individual &mdash; shaping a more connected, convenient and compassionate health experience. At CVS Health&reg;, you&rsquo;ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger &ndash; helping to simplify health care one person, one family and one community at a time.</p><p></p><h2 class="jobSectionHeader"><b>
Aetna, a CVS Health Company, is one of the oldest and largest national insurers. That experience gives us a unique opportunity to help transform health care. We believe that a better care system is more transparent and consumer-focused, and it recognizes physicians for their clinical quality and effective use of health care resources.</b><br>
<br>
<b>In this role you will:</b></h2><ul><li><h2 class="jobSectionHeader"><b>
Provide oversight for medical policy implementation.</b></h2></li><li><h2 class="jobSectionHeader"><b>
Participate in the development, implementation, and evaluation of clinical / medical programs and expand Aetna's medical management programs to address member needs across the continuum of care.</b></h2></li><li><h2 class="jobSectionHeader"><b>
Support the Medical Management staff ensuring timely and consistent responses to members and providers.</b></h2></li></ul><h2 class="jobSectionHeader"><b>
</b></h2><h2 class="jobSectionHeader"><b>
As a Medical Director you will:
</b></h2><ul><li><h2 class="jobSectionHeader"><b>Focus primarily on overseeing utilization review / quality assurance and be responsible for predetermination reviews and reviews of claim determinations.</b></h2></li><li><h2 class="jobSectionHeader"><b>
This includes Prior Authorization / Pre Certification / Concurrent Reviews / Peer to Peer Calls / First Level Appeals / Special Projects and Committee participation when needed.</b></h2></li><li><h2 class="jobSectionHeader"><b>
The Medical Director will provide clinical, coding, and reimbursement expertise as well as directing case management when necessary.</b></h2></li><li><h2 class="jobSectionHeader"><b>
In this role you will provide clinical expertise and business direction in support of medical management programs through participation in clinical team activities.</b></h2></li><li><h2 class="jobSectionHeader"><b>
The Medical Director will act as lead business and clinical liaison to network providers and facilities to support the effective execution of medical services programs by the clinical teams.</b></h2></li></ul><h2 class="jobSectionHeader"><b><br>
</b></h2><h2 class="jobSectionHeader"><br>
<br>
<b>Required Qualifications:</b></h2><ul><li><b>2 or more years of experience in Health Care Delivery System e.g., Clinical Practice and Health Care Industry.</b></li><li><b>Active and current medical license without encumbrances</b></li><li><b>M.D. or D.O., Board Certification in a recognized specialty including post-graduate direct patient care experience.</b></li></ul><h2 class="jobSectionHeader"><br>
<b>
Preferred Qualifications:</b></h2><ul><li><b>Five or more years of direct patient care experience</b></li><li><b>Preferred licensed in TX, CA, or FL</b></li><li><b>Previous UM experience with a Health plan/payor experience.</b></li><li><b>Electronic medical systems/record experience</b></li><li><b>Managed Care experience</b></li><li><b>Board certification in Internal Medicine, Family Medicine, Emergency Medicine, or Med/PM&amp;R</b></li></ul><h2 class="jobSectionHeader"><br>
<b>
Education</b></h2><ul><li><b>Active and current state medical license without encumbrances</b></li><li><b>M.D. or D.O., Board Certification in a recognized specialty including post-graduate direct patient care experience</b></li></ul><p></p><p><b>
Pay Range</b></p><p>
The typical pay range for this role is:</p><p></p>
$174,070.00 - $374,920.00<p><br>
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company&rsquo;s equity award program.</p><p><br>
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.</p><p></p><p><b>
Great benefits for great people</b></p><p></p><p>
We take pride in our comprehensive and competitive mix of pay and benefits &ndash; investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:</p><ul><li><p><b>
Affordable medical plan options,</b> a <b>401(k) plan </b>(including matching company contributions), and an <b>employee stock purchase plan</b>.</p></li><li><p><b>
No-cost programs for all colleagues </b>including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</p></li><li><p><b>
Benefit solutions that address the different needs and preferences of our colleagues</b> including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</p></li></ul><p></p><p>
For more information, visit https://jobs.cvshealth.com/us/en/benefits</p><p></p>
We anticipate the application window for this opening will close on: 04/30/2026<p></p><p>
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.</p></div>

Medical Director - Commercial

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