Medical Director of Utilization and Medical Management

3 days ago

Oakland, California, United States Altais, Inc. Full time
About Our Company

At Altais, Inc., we're committed to revolutionizing the healthcare system by providing innovative clinical support tools, technology, and services that empower physicians to deliver exceptional patient care. Our mission-driven organization values bold and curious clinicians and innovators who share our passion for improving healthcare experiences.

About Your Team

We're a dynamic and high-performing clinical team of over 4,000 physicians, serving more than 500,000 patients across 40 cities in California. If you're passionate about reshaping healthcare and want to work for a mission-driven organization that values innovation and new ideas, we'd love to meet you.

About Your Work

The Part-Time Medical Director of Utilization and Medical Management will report directly to the Senior Medical Director and work closely with the Altais Clinical Leadership team to ensure the delivery of high-quality, efficient, and comprehensive healthcare services throughout the continuum of care. This role will facilitate and provide information and education for Altais to enhance understanding and skill development in medical, financial, and utilization practice functions of managed care.

Key Responsibilities:
  • Develop and implement Utilization Management policy and procedures.
  • Enhance the overall efficiency and quality of care for patients served by Altais through effective network management.
  • Develop and maintain collaborative relationships with key providers, particularly thought leaders, across the Altais service delivery footprint.
  • Provide cooperative leadership and direction to the UMC (Utilization Management Committee) Primary Care Physicians (PCP) and Specialist Physicians as assigned by the Senior Medical Director.
  • Interface with health plans regarding benefits, coverage issues, and appeals.
  • Collaborate with physician leaders across all healthcare settings to ensure patient care is managed in a cost-containment manner without compromising health outcomes.
Requirements:
  • Strong clinical skills and knowledge of utilization management techniques.
  • Effective interpersonal and communication skills.
  • Ability to secure trust and confidence of employees at all levels.
  • Doctor of Medicine degree; valid California licensure; Current Board certification, preferably in a broad-based specialty.
  • A minimum of seven years as a practicing inpatient and outpatient physician in a managed care environment.
What We Offer:

We provide a competitive compensation package that recognizes your experience, credentials, and education, alongside a robust benefits program to meet your needs. Our anticipated pay range for this role is listed in our salary posting for transparency, but may vary based on factors including your qualifications, skills, and experience.

Altais, Inc. and its subsidiaries and affiliates are committed to protecting the privacy and security of the personal information you provide to us. Please refer to our 'CPRA Privacy Notice for California Employees and Applicants' to learn how we collect and process your personal information when you apply for a role with us.

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