Medicare Medical Director (MD)

OUR COMMITMENT TO A HUMAN HIRING PROCESS

We believe every candidate deserves thoughtful wedo not use AI or automated systems toreview applications. Every application is reviewed bya realhumanmember of our team. Because we take the time to give each submission the attention it deserves our review process may take a little longer and we genuinely appreciate your patience as we work through applications carefully and respectfully.

SERVICE AREA PREFERENCE

While we encourage all interested applicants to apply we do give priority to those who live in or near our service counties: Santa Cruz Monterey Merced San Benito and Mariposa. Our mission ofaccessible quality health care guided by local innovationleadseverything we do and having team members who are connected to the communities we serve strengthens our ability to deliver on that commitment.

*This is a hybrid position with the expectation to work in our service area(s) 2-3 days per month. The Alliance service area includes Santa Cruz Monterey Merced San Benito and Mariposa counties.

We have an opportunity to join the Alliance as the Medicare Medical Director (MD).

WHAT YOULL BE RESPONSIBLE FOR

Reporting to the Chief Medical Officer this position:

• Acts as the Alliances Medicare Dual Eligible Special Needs Plan (D-SNP) clinical subject matter expert
• Provides specialized clinical D-SNP leadership within a variety of Health Services functional areas
• Develops and improves relationships with internal and external stakeholders including the professional medical community and maintains and enhances communications with similar Health Plan organizations
• Participates in all aspects of regulatory compliance related to D-SNP and Health Services functions

THE IDEAL CANDIDATE

• Enjoys a fast-paced demanding environment that requires critical thinking to develop and implement effective solutions in a timely manner
• Is dedicated to caring for Medicare and/or Medicaid patients while addressing the social determinants of health
• Works with a broad and diverse group of stakeholders to problem solve and build cutting-edge programs
• Has the latitude to think broadly make operational and strategic decisions and oversee the implementation and continuous process improvement related to key internal and external priorities

WHAT YOULL NEED TO BE SUCCESSFUL

To read the full position description and list of requirementsclick here.

• Knowledge of:
  • The needs of the Medicare population and/or Medicare Plan administration
  • The Medicare D-SNP program and related regulations CMS D-SNP STARS Rating System and managed care
  • Medical programs administration quality improvement and/or informatics
  • Data collection and management practices as related to utilization and quality of medical care
  • Promoting and applying change management principles
• Ability to:
  • Provide clinical oversight and leadership of the Medicare D-SNP program
  • Analyze issues and think critically to ensure success in leading system change make informed operational and strategic decisions and oversee implementation and continuous process improvement related to key internal and external priorities
  • Audit analyze and assess medical records and other health care data
  • Interpret regulations legal and contractual language policies and procedures
• Education and Experience:
  • Doctor of Medicine current license to practice medicine issued by the State of California Board certification in a specialty recognized by the American Board of Medical Specialties and a minimum of three years of experience as an attending physician with the Medicare population or three years of experience as an attending physician which included a minimum of two years of Medicare Plan administration experience; or an equivalent combination of education and experience may be qualifying

OTHER INFORMATION

• We are in a hybrid work environment and we anticipate that the interview process will take place remotely via Microsoft Teams.
• While some staff may work full telecommuting schedules attendance at quarterly company-wide events or department meetings will be expected.
• In-office or in-community presence may be required for some positions and is dependent on business need. Details about this can be reviewed during the interview process.

COMPENSATION INFORMATION

The hiring ranges below represent a goodfaith estimate of what we expect to pay for this role upon hire and are not the full compensation ranges. Employees typically have opportunities for growth within the full compensation range over time based on performance and merit. Final compensation will be determined by our compensation philosophy analysis of the selected candidates qualifications (direct or transferable experience related to the position education or training) as well as other factors (internal equity market factors and geographic location).

The applicable salary ranges are based on work location and are aligned to a zone according to the cost of labor in your area. All ranges are subject to change in the future. We are happy to provide the full compensation range for the role answer any questions that you have or share the applicable pay zone for your location if its not one of the typical areas included below. You can reach out to and a member from our Talent Acquisition team will be in touch.

Typical areas in Zone 1: Santa Cruz San Benito and Monterey Counties Bay Area Sacramento Los Angeles and San Diego areas

Typical areas in Zone 2: Mariposa and Merced Counties Fresno area Bakersfield Eastern California San Luis Obispo area and the Central Valley (except Sacramento)

OUR BENEFITS

Available for all regular Alliance employees working more than 30 hours per benefits are available on a pro-rated basis for part-time employees. These benefits are unavailable to temporary employees while on an assignment with the Alliance.

• Medical Dental and Vision Plans
• Ample Paid Time Off
• 12 Paid Holidays per year
• 401(a) Retirement Plan
• 457 Deferred Compensation Plan
• Robust Health and Wellness Program
• Onsite EV Charging Stations

ABOUT US

We are a group of over 500 dedicated employees committed to our mission of providing accessible quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us.

Join us at Central California Alliance for Health (the Alliance) where you will be part of a culture that is respectful diverse professional and fun and where you are empowered to do your best work. As a regional non-profit health plan we serve members in Mariposa Merced Monterey San Benito and Santa Cruz counties. To learn more about us take a look at ourFact Sheet.

The Alliance is an equal employment opportunity employer. Qualified applicants will receive consideration for employment without regard to race color religion sex (including pregnancy) sexual orientation gender perception or identity national origin age marital status protected veteran status or disability status. We are an E-Verify participating employer

At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time ongoing basis without current or future needs for any type of employer supported or provided sponsorship.