Medical Director

About the role

Assist the Chief Medical Officer in directing and coordinating medical management, quality improvement, and credentialing functions for the business unit. Provide medical leadership for utilization management, cost containment, and quality improvement activities.

Key responsibilities

• Perform medical review activities for utilization review, quality assurance, and complex or experimental services.
• Support performance improvement initiatives for capitated providers and develop physician education programs.
• Conduct regular rounds for high‑risk patients, collaborating with care‑management teams to optimize outcomes.
• Collaborate with clinical teams, network providers, appeals, and medical/pharmacy consultants on complex cases and medical‑necessity appeals.
• Identify utilization trends, adverse patterns, and clinical quality improvement opportunities to reduce unwarranted variation.
• Represent the business unit on state and ad‑hoc committees and may present on medical philosophy and policies.

Required profile

• Medical Doctor (MD) or Doctor of Osteopathy (DO) with active practice.
• Board certification in a specialty recognized by the American Board of Medical Specialists or the American Osteopathic Association (Psychiatry required).
• Current unrestricted Georgia medical license.
• Experience in utilization management and knowledge of quality accreditation standards preferred.
• Coursework or experience in health administration, financing, insurance, or personnel management is advantageous.

What we offer

• Competitive salary ranging from $215,000 to $408,500 per year.
• Comprehensive benefits including health insurance, 401(k) and stock purchase plans.
• Tuition reimbursement, paid time off plus holidays.
• Flexible work arrangements – remote, hybrid, field or office schedules.