Medical Director, Clinical Operations
2 days ago
Description Are you passionate about evidence-based medicine and improving care for Medicare Advantage members? UCLA Health Medicare Advantage Plan is looking for a dedicated and forward-thinking Medical Director, Clinical Operations to help shape the future of our plan. In this key leadership role, you’ll work closely with the Medical Director, Department of Health Services and play a vital part in scaling Health Services functions. Your work will directly support our Health Services Department in delivering high-quality, appropriate, and patient-centered care. What you’ll do: Provide clinical determinations for UM (prior authorizations, concurrent reviews, appeals, grievances, peer-to-peer). Partner with clinical and operational leaders to ensure high-quality, cost-effective care. Collaborate with the Pharmacy team on safe, effective medication use; participate in drug review rounds and P&T Committee. Contribute to interdisciplinary care team rounds for complex case management. The UCLA Health salary range for this title code is $123,500-$302,600/annually. Please note that the department's target pay range is $250,000- $300,000/annually. Note: This position is a flexible-hybrid role that requires one-day a week on-site in Los Angeles, CA. Qualifications We’re seeking a dynamic and strategic individual with: Required: MD or DO degree, required Active, unrestricted California State Medical License, required Completion of residency in an adult-based primary care specialty (e.g., Internal Medicine, Family Medicine, Geriatrics), required Board Certification in an ABMS, ABOS, or AOA-recognized specialty (preferably Internal Medicine or Family Medicine), required 5 or more years of direct patient care experience post residency, required Minimum of 2 years of experience in Utilization Management 2 or more years of experience working managed care Knowledge of Medicare Advantage experience with utilization management, quality improvement, or case management Ability to lead and influence in a matrixed organizational structure Strong verbal and written communication skills Strategic thinker with a collaborative, team-oriented approach Proficiency in EMR, health plan platforms and productivity tools High integrity and commitment to ethical medical practice Preferred: Minimum of 2 years medical leadership experience Familiarity with evidence-based guidelines, NCD, LCD, MCG, and ICD/CPT coding Experience with population health and CMS STAR ratings #J-18808-Ljbffr
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Medical Director, Clinical Operations
2 days ago
Los Angeles, United States The Regents of the University of California Full timeSalary Range: $123,500 - $302,600 annually Employment Type: Indefinite Primary Duties and Responsibilities Are you passionate about evidence-based medicine and improving care for Medicare Advantage members? UCLA Health Medicare Advantage Plan is looking for a dedicated and forward-thinking Medical Director, Clinical Operations to help shape the future of our...
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Los Angeles, United States The Regents of the University of California Full timeA prominent university health system in Los Angeles is seeking a Medical Director, Clinical Operations to enhance care for Medicare Advantage members. This flexible-hybrid role involves clinical determinations, collaboration with clinical leaders, and interdisciplinary team engagement. Ideal candidates will possess an MD/DO degree, California Medical...
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Medical Director, Clinical Operations
3 days ago
Los Angeles, CA, United States University of California Full timeDescription Are you passionate about evidence-based medicine and improving care for Medicare Advantage members? UCLA Health Medicare Advantage Plan is looking for a dedicated and forward-thinking Medical Director, Clinical Operations to help shape the future of our plan. In this key leadership role, you'll work closely with the Medical Director, Department...
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Associate Director, Clinical Operations
1 week ago
Los Angeles, California, United States Cedars-Sinai Medical Center Full time $133,000 - $200,000 per yearJob ID 13169Location Los Angeles, California, United StatesJob Category Clinical OperationsDate posted 11/04/2025Save JobEmployees: Apply HereJob DescriptionGrow your career at Cedars-SinaiAt Cedars-Sinai, we're motivated by a collective spirit of innovation and the challenge to continuously improve. Above all, we a real passion for helping others. Day after...
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Medical Director
4 weeks ago
Los Angeles, United States AB Hires and Consulting LLC Full timeA healthcare management organization in Los Angeles is seeking a Medical Director to oversee clinical operations and support care coordination in a Medicare Advantage-focused model. This role is ideal for early-career physicians looking for a leadership opportunity in a collaborative environment emphasizing chronic disease and administrative streamlining....
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Clinical Research Site Director
1 week ago
Los Angeles, CA, United States C-Clinical at Los Angeles Full timeClinical Research Site Director – Oncology A respected hematology and oncology research center in Los Angeles is looking for a Clinical Research Site Director to guide daily operations and support the success of complex cancer trials. This opportunity allows you to influence the advancement of oncology studies, contribute to life-changing treatment...
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Associate Director, Clinical Operations
13 hours ago
Los Angeles, California, United States Cedars-Sinai Full timeJob DescriptionGrow your career at Cedars-SinaiAt Cedars-Sinai, we're motivated by a collective spirit of innovation and the challenge to continuously improve. Above all, we share a real passion for helping others. Day after day, from department to department, our people give their all to create a community unlike any other. This is just one of the many...
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Medical Director, Clinical Ops
2 days ago
Los Angeles, United States Nahse Full timeA leading health organization is looking for a Medical Director, Clinical Operations to enhance care for Medicare Advantage members. This role involves clinical determinations, collaboration with operational leaders, and working within a complex case management framework. Candidates need an MD or DO degree, California medical license, and 5+ years of patient...
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Remote Medical Director: Clinical Coverage
4 weeks ago
Los Angeles, United States Optum Full timeA leading healthcare organization is seeking a Medical Director to enhance clinical operations and support within their Enterprise Clinical Services. This role involves conducting coverage reviews, collaborating with multidisciplinary teams, and ensuring quality medical care. Ideal candidates will possess an M.D or D.O, board certification, and significant...
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Medical Director
5 days ago
Los Angeles, United States MASC Medical Full timeJob DescriptionCompensation: $250,000 – $400,000 (experience-based)Benefits: Paid Time Off (PTO), CME allowance, 401(k)Schedule: Full-Time | Fully RemotePosition OverviewCan work from any state but must be available for work in PST and be licensed in California.We are seeking an experienced and mission-driven physician leader to serve as the Program...
