Associate Medical Director

2 weeks ago

Dallas, TX, United States MD Staff Pointe Full time
Job Description

Hot off the press I'm reaching out with a brand-new Associate Medical Director - OB/GYN opportunity in Dallas, Texas with a mission-driven health plan focused on delivering high-quality, affordable care to underserved populations.

This is an outstanding leadership role for a physician passionate about improving outcomes, driving innovation, and supporting coordinated care.

Position Overview

The Associate Medical Director will take a hands-on approach in supporting and overseeing clinical activities across utilization management, quality initiatives, pharmacy collaboration, provider performance, and member/provider education.

Key Responsibilities Include:

  • Reviewing prior authorizations and appeals for medical necessity
    • Conducting peer-to-peer calls to support utilization management
    • Providing clinical oversight for UM, disease management & quality programs
    • Developing and refining clinical guidelines and medical policies
    • Analyzing provider performance and participating in credentialing reviews
    • Supporting oversight of the pharmacy benefit
    • Assisting in fraud, waste & abuse program oversight
    • Contributing to annual systemwide planning and goals
    • Supporting educational needs for members and providers
    • Representing the health plan with state/local agencies as assigned
    • Leading process improvement efforts to enhance workflows
    • Serving on clinical and community committees


Why This Opportunity Stands Out:

Mission-driven work improving access & outcomes
Strategic leadership role with major impact
Strong internal support & collaborative culture
Located in vibrant Dallas, TX

If this aligns with what you're looking for, I'd be happy to share additional details or set up a confidential call.

Looking forward to connecting,

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