Medical director jobs in Aliso Viejo, CA - 471 jobs

What you can expect! Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience! Reporting to the Vice President of Health Services, the Senior Medical Director Policy & Outcomes (Sr. Medical Director - P&O) is responsible for the strategic oversight of IEHP Medical Policies and clinical leadership around member health outcomes. The Sr. Medical Director - P&O oversees the day-to-day operations as it relates to developing, executing, leading and updating guidelines, policies, clinical pathways, and communications enabling effective health outcomes, as well as effective health plan performance as per DHCS, DMHC, CMS, and CCA clinical requirements. This leader serves as the accountable medical leader for clinical activities related to key activities including quality management, grievance and appeals, delegation oversight, and population health management. The Sr. Medical Director - P&O also works in partnership with the appropriate cross functional departments to monitor the impact of policy outcomes through regular reporting, metrics, initiatives, and other improvement activities. This position is responsible for leading regulatory audits for all its relevant domains. Commitment to Quality: The IEHP Team is committed to incorporate IEHP's Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation. Additional Benefits Perks IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more. Competitive salary Hybrid schedule State of the art fitness center on-site Medical Insurance with Dental and Vision Life, short-term, and long-term disability options Career advancement opportunities and professional development Wellness programs that promote a healthy work-life balance Flexible Spending Account - Health Care/Childcare CalPERS retirement 457(b) option with a contribution match Paid life insurance for employees Pet care insurance Key Responsibilities Lead the development and execution of creating and/or updating medical policies and procedures to align with health plan regulatory requirements. Ensure guidelines and clinical pathways are updated with best practices, along with appropriate downstream connections to utilization management, population health, and other compliance and regulatory activities Lead, develop and implement clinical programs and medical policies to align with IEHP's strategic priorities in order to improve member safety, quality of care and outcomes Lead clinically, through strong partnerships with other departments for activities related to member outcomes, quality improvement, grievance and appeals, and network corrective action plans. Develop and increase collaborative relationships with internal departments. Assure interdepartmental collaboration and communication with key business departments, including, but not limited to, compliance, member experience, provider relations, and claims. Serve as a liaison with providers, county public health partners and oversight agencies as assigned. Monitor network performance proactively to ensure adherence to policy standards. Develop and implement appropriate internal initiatives to address any issues impacting member outcomes Co-leadership with the Sr. Medical Director of Health Servies to advance IEHP's Mission, Vision and Values. Work in partnership with the Senior Medical Director focusing on UM to coordinate daily huddles, develop work schedules, adherence to department metrics and KPIs, and training of medical staff. Manage medical directors, as well physician reviewers, working in the domains of policy, outcomes, quality management and clinical guideline development. Provide clinical direction to the Health Service team and act as a resource to all IEHP departments responsible for providing or coordinating clinical services to IEHP members. Direct, implement, and/or enhance medical policy, internal policies, and job aids as it relates to member safety and quality management activities, clinical guideline development, delegation and oversight, credentialing, peer review, and compliance related activities. Ensure medical decisions are rendered by qualified medical personnel, unhindered by fiscal or administrative management, with timely and appropriate use of UM criteria and guidelines. Direct clinical and workflow training for medical directors and physician reviewers within their oversight. Ensure medical personnel of the Plan and its delegates follow IEHP policies, protocols and rules of conduct consistent with the values of IEHP. Identify gaps in policies or activities relating to member outcomes and implement strategic, effective solutions. Serve as a primary point of contact for clinical, quality and performance issues for medical directors at delegated IPAs, as well as for providers in the IEHP direct network. Support other departments as needed to ensure timely completion of member grievances and appeals as required for regulatory compliance. Provide clinical leadership, support and/or guidance including, but not limited to, the following areas: Pre-admission authorization Prospective, concurrent and retrospective review Inpatient case review Inpatient claims reviews Utilization review Member case management Provider incentive programs Credentialing, Peer Review and Member Safety Subcommittees Pharmacy and Therapeutics Subcommittee NCQA Accreditation Reviews State mandated benefits to ensure IEHP is in full compliance through its providers. Perform any other duties as required to ensure Health Plan operations and department business needs are successful Qualifications Education & Requirements Seven (7) years of post-residency experience in a recognized medical specialty or practice, which must have included at least (3) years of medical administrative experience required Minimum of five (5) years of managed care or health plan leadership experience with proven track record of leading high performing physician teams Experience working with clinical practice guidelines and evidenced based criteria sets Has exposure to working with regulatory agencies Medical Director for an IPA, medical group, or CA HMO highly desirable Medical specialty/practice experience preferably in the state of California Doctorate of Medicine from an accredited institution required Certification by one (1) of the American Specialty Boards required Completion of an accredited residency program required. Possession of an active, unrestricted, and unencumbered Physician's and Surgeon's Certificate issued by the State of California required A physician certified in a state other than California may be employed prior to receipt of California certification provided that an application for a California physician and surgeon's certificate is filed in the state of California prior to date of appointment. Key Qualifications Valid California Driver's License preferred Possesses in depth comprehensive knowledge of: Managed Care principles Administrative practices and procedures (including but not limited to: credentialing and risk management, rules regulations, policies, and standards related to managed care) Principles of effective supervision and organization; methods, techniques, practices, principles, and literature in the broad field of medical sciences The principles of medical practice in a variety of settings (inpatient, outpatient, subacute, etc) Familiarity with local healthcare organizations and/or local practice experience is preferred Highly Organized, Effective Communication Skills, Microcomputer applications such as Microsoft Word, Excel, and Access. Proven execution skills Assertive communicator Demonstrate effective leadership of other physicians and clinical staff A track record of leading with accountability is required Travel within California Start your journey towards a thriving future with IEHP and apply TODAY! Work Model Location This position is on a hybrid work schedule. (Mon & Fri - remote, Tues - Thurs onsite in Rancho Cucamonga, CA.) Travel within California Pay Range USD $280,841.60 - USD $393,182.40 /Yr.

Clinical Operations Medical Director Carelon Medical Benefit Management Radiation Oncology Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. A proud member of the Elevance Health family of companies, Carelon Medical Benefits Management, formerly AIM Specialty Health, is a benefit-management leader in Illinois. Our platform delivers significant cost-of-care savings across an expanding set of clinical domains, including radiology, cardiology and oncology. The Clinical Operations Medical Director is responsible for supporting the medical management staff ensuring timely and consistent medical decisions to members and providers. How you will make an impact: * Ensures timely completion of clinical case reviews for their board certified specialty. * Makes physician to physician calls to gather medical appropriate information in order to make medical necessity determinations for services requested. * Makes medical necessity determinations for grievance and appeals appropriate for their specialty. * Ensures consistent use of company medical policies when making medical necessity decisions. * Brings to their supervisors attention, any case review decisions that require Medical Director review or policy interpretation. Mimimum Requirements: * Requires MD or DO and Board certification approved by one of the following certifying boards is required, where applicable to duties being performed, American Board of Medical Specialties (ABMS) or American Osteopathic Association (AOA). * Must possess an active unrestricted medical license to practice medicine or a health profession. * Minimum of 1 year of experience with clinical case reviews for medical necessity. The minimum of 1 year of experience with clinical case reviews would be waived for the following specific specialties only; Cardiology, Oncology, and Interventional Pain specialties. Board certification in a medical specialty required. Preferred Skills, Capabilities, and Expereinces * Board certified in Radiation Oncology strongly preferred For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $225,036 to $352,236 Locations: California; District of Columbia (Washington, DC), New Jersey, New York, In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Clinical Operations Medical Director Carelon Medical Benefit Management Radiation Oncology Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. A proud member of the Elevance Health family of companies, Carelon Medical Benefits Management, formerly AIM Specialty Health, is a benefit-management leader in Illinois. Our platform delivers significant cost-of-care savings across an expanding set of clinical domains, including radiology, cardiology and oncology. The Clinical Operations Medical Director is responsible for supporting the medical management staff ensuring timely and consistent medical decisions to members and providers. How you will make an impact: * Ensures timely completion of clinical case reviews for their board certified specialty. * Makes physician to physician calls to gather medical appropriate information in order to make medical necessity determinations for services requested. * Makes medical necessity determinations for grievance and appeals appropriate for their specialty. * Ensures consistent use of company medical policies when making medical necessity decisions. * Brings to their supervisors attention, any case review decisions that require Medical Director review or policy interpretation. Mimimum Requirements: * Requires MD or DO and Board certification approved by one of the following certifying boards is required, where applicable to duties being performed, American Board of Medical Specialties (ABMS) or American Osteopathic Association (AOA). * Must possess an active unrestricted medical license to practice medicine or a health profession. * Minimum of 1 year of experience with clinical case reviews for medical necessity. The minimum of 1 year of experience with clinical case reviews would be waived for the following specific specialties only; Cardiology, Oncology, and Interventional Pain specialties. Board certification in a medical specialty required. Preferred Skills, Capabilities, and Expereinces * Board certified in Radiation Oncology strongly preferred For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $225,036 to $352,236 Locations: California; District of Columbia (Washington, DC), New Jersey, New York, In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. Job Level: Non-Management Non-Exempt Workshift: 1st Shift (United States of America) Job Family: MED > Licensed Physician/Doctor/Dentist Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Definition Under general supervision, the Medical Professional Expert provides assistance and support in accordance with assignments and directions from the supervisor. Medical Professional Experts: * Have specialized knowledge or expertise not generally required of or found in the classifications established by the District. * Must be specially trained, experienced, or competent to perform expert services. * Are used on a temporary basis for a specific project or projects. * Terms of employment will be described in the Professional Expert Agreement Non-academic, non-classified Professional Experts are not part of classified service. Non-academic, non-classified short-term employees are at-will employees and have no entitlement rights to any position in the District. Professional Expert employment shall not result in the displacement of Classified personnel. * Retired CalPERS Annuitants: may not exceed 960 hours in a fiscal year (July 1 through June 30)* REPRESENTATIVE DUTIES: Provides clinic directives, standing orders and advises on Health Center protocols. Qualifications and Physical Demands * Education, experience and/or training that is directly related to job category is required. Conditions of Employment This is a medical professional expert position. The District reserves the right to extend, modify, or eliminate this position based upon available funds. The effective dates of employment will be arranged with the supervisor. Note: Applicants must be authorized to work for ANY employer in the U.S. We are unable to sponsor or take over sponsorship of an employment Visa at this time. This is a recruitment for an applicant POOL to fill temporary/short-term assignments on an as-needed basis. Departments or Divisions will refer to the POOL of applications on file to fill temporary/short-term assignments as the need arises. Applications will remain in the pool for one year. You will be contacted by the hiring manager should the department/division be interested in scheduling an interview. Please do not call the Office of Human Resources regarding the status of your application. Employment is contingent upon verification of employment history, background verification as governed under Education Code requirements, eligibility to work in the United States, and approval by the CCCD Board of Trustees. The hours of work and effective date of employment will be arranged with the supervisor. * Regular attendance is considered an essential job function; the inability to meet attendance requirements may preclude the employee from retaining employment. * The person holding this position is considered a mandated reporter under the California Child Abuse and Neglect Reporting Act and is required to comply with the requirements set forth in Coast Community College District policies, procedures, and Title IX. (Reference: BP/AP 5910) * The Coast Community College District celebrates all forms of diversity and is deeply committed to fostering an inclusive environment within which students, staff, administrators, and faculty thrive. Individuals interested in advancing the District's strategic diversity goals are strongly encouraged to apply. Reasonable accommodations will be provided for qualified applicants with disabilities who self-disclose. Application materials must be electronically submitted on-line at ******************** employment. Incomplete applications and application materials submitted by mail will not be considered. Additional Information APPLICATION REQUIREMENTS: To be considered for this opportunity, you must submit a COMPLETE application packet. A complete application packet includes: * A complete Coast Community College District Online Employment Application. * Answers to ALL Supplemental Questions, if any (please provide clear and detailed responses, where applicable, as they will be carefully evaluated to determine the most qualified candidate(s) to be invited for an interview; please do not paste your resume, put "see resume" or "N/A", or leave blank). If you are invited for an interview you may be asked to provide a copy of your transcripts and a Letter of Recommendation written by an Instructor. Candidates will also be responsible for all travel expenses if selected for an interview, the Coast Community College District does not reimburse for candidate travel expenses. Disability Accommodations If you require accommodations in the Application or Examination Process, please notify Human Resources by calling **************. PHYSICAL DEMANDS AND WORK ENVIRONMENT: * The physical demands are representative of those that must be met by an employee to successfully perform the essential functions of this job. * The work environment characteristics are representative of those an employee encounters while performing the essential functions of this job. * Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * A detailed list of physical demands and work environment is on file and will be provided upon request.

Medical Director - South Bay (Torrance) AAHA Accredited, Private-Owned, Small Animal Hospital in Torrance is looking to bring on a Medical Director. Western Veterinary Group is a modern, privately owned hospital with a great reputation here in the South Bay. The hospital has a strong team of doctors and staff in place, but is looking to add a Medical Director level doctor to run point as the leader of the pack. If you're looking to join a private practice that is well run and practices the highest quality medicine, this is the spot for you. The hospital has won "South Bay's Best" awards, is AAHA accredited and has been a staple in the community since 2008. As the Medical Director, you'll be seen as the leader of the medical team and relied on to guide fellow doctors when called upon. The specific structure of the role can be structured in a way to allow you to do what you enjoy the most whether that be focusing on surgery or focusing on mentorship in this elevated role. As a Medical Director, you'll enjoy additional CE, PTO and other additional perks as well. The Good Stuff: 4 doctor team Experienced RVTs and support team that play a significant role 3 Weeks+ of PTO Lucrative Salary + ProSal Quality health insurance and high-contributing 401K, CE, dues and fees Collaborative Team w/ Multiple doctors mentored through the years 1 Hour Blocked Daily for callback and note time Flexibility for schedule shifts and a true private-practice culture 30-60 min appointment times In-house lab, ultrasound, digital radiography, lasers and more. Apply: Submit your CV or Email Brett at ******************** for more information.

Job DescriptionBenefits: Competitive salary Flexible schedule Opportunity for advancement The Medical Director for the Dermatology Office provides clinical leadership, medical oversight, and ensures the delivery of safe, high-quality, evidence-based dermatologic care. This role is responsible for supervising clinical providers, establishing medical protocols, ensuring regulatory compliance, and supporting the overall clinical and operational success of the practice. Key Responsibilities Clinical Oversight Provide medical supervision and oversight of dermatology providers (MDs, PAs, NPs, MAs, aestheticians as applicable). Establish, review, and update clinical protocols, treatment guidelines, and standard operating procedures. Ensure all dermatologic services are delivered in accordance with current best practices and evidence-based medicine. Be available for clinical consultation, case review, and escalation of complex or high-risk cases. Quality & Compliance Ensure compliance with all federal, state, and local regulations, including scope of practice, licensing, and supervision requirements. Maintain compliance with HIPAA, OSHA, infection control, and patient safety standards. Participate in quality assurance, peer review, and risk management activities. Review and approve clinical documentation, consent forms, and patient education materials as needed. Leadership & Collaboration Serve as the clinical leader and liaison between medical staff and practice management. Support recruitment, onboarding, and training of clinical providers. Foster a culture of professionalism, patient-centered care, and clinical excellence. Participate in staff meetings, clinical trainings, and performance improvement initiatives. Business & Operational Support Provide input on service offerings, clinical workflows, and new dermatologic treatments or technologies. Support credentialing, payer enrollment, and chart review requirements as needed. Assist with audits, inspections, and payer reviews when applicable. Collaborate with leadership on strategic planning and growth initiatives. Qualifications Required MD or DO with board certification or board eligibility in Dermatology. Active, unrestricted medical license in the state of practice. DEA registration (if applicable). Minimum of 35 years of clinical dermatology experience. Experience supervising or collaborating with advanced practice providers. Preferred Prior experience as a Medical Director or in a leadership role. Experience in outpatient dermatology, cosmetic dermatology, or med spa settings. Strong knowledge of regulatory and compliance standards. Excellent communication, leadership, and organizational skills. Physical & Work Requirements Ability to perform clinical and administrative duties. May require on-site presence, remote availability, or a hybrid model depending on practice needs.

Provides medical oversight and expertise in appropriateness and medical necessity of services provided to members, targeting improvements in efficiency and satisfaction for both members and providers and ensuring members receive the most appropriate care in the most effective setting. Contributes to overarching strategy to provide quality and cost-effective member care. Experience conducting Medi-cal reviews Essential Job Duties • Determines appropriateness and medical necessity of health care services provided to plan members. • Supports plan utilization management program and accompanying action plan(s), which includes strategies to ensure high-quality member care - ensuring members receive the most appropriate care at the most effective setting. •Evaluates effectiveness of utilization management (UM) practices - actively monitoring for over and under-utilization. • Educates and interacts with network, group providers and medical managers regarding utilization practices, guideline usage, pharmacy utilization and effective resource management. • Assumes leadership relative to knowledge, implementation, training, and supervision of the use of the criteria for medical necessity. • Participates in and maintains the integrity of the appeals process, both internally and externally. • Responsible for investigation of adverse incidents and quality of care concerns. • Participates in preparation for national committee for quality assurance (NCQA) and utilization review accreditation commission (URAC) certifications. • Provides leadership and consultation for NCQA standards/guidelines for the plan including compliant clinical quality improvement activity (QIA) in collaboration with clinical leadership and quality improvement teams. • Facilitates conformance to Medicare, Medicaid, NCQA and other regulatory requirements. • Reviews quality referred issues, focused reviews and recommends corrective actions. • Conducts retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. • Attends or chairs committees as required such as credentialing, Pharmacy and Therapeutics (P&T) and other committees as directed by the chief medical officer. • Evaluates authorization requests in timely support of nurse reviewers, reviews cases requiring concurrent review and manages the denial process. • Monitors appropriate care and services through continuum among hospitals, skilled nursing facilities and home care to ensure quality, cost-efficiency, and continuity of care. • Ensures that medical decisions are rendered by qualified medical personnel and not influenced by fiscal or administrative management considerations, and that care provided meets the standards for acceptable medical care. • Ensures medical protocols and rules of conduct for plan medical personnel are followed. • Develops and implements plan medical policies. • Provides implementation support for quality improvement activities. • Stabilizes, improves and educates primary care physicians and specialty networks; monitors practitioner practice patterns and recommends corrective actions as needed. • Fosters clinical practice guideline implementation and evidence-based medical practices. • Utilizes information technology and data analytics to produce tools to report, monitor and improve utilization management. • Actively participates in regulatory, professional and community activities. Required Qualifications • At least 3 years health care experience, including at least 2 years of medical practice experience, or equivalent combination of relevant education and experience. • Active and unrestricted Doctor of Medicine (MD) or Doctor of Osteopathy (DO) license in state of practice. • Board certification. • Working knowledge of applicable national, state, and local laws and regulatory requirements affecting medical and clinical staff. • Ability to work cross-collaboratively within a highly matrixed organization. • Strong organizational and time-management skills. • Ability to multi-task and meet deadlines. • Attention to detail. • Critical-thinking and active listening skills. • Decision-making and problem-solving skills. • Strong verbal and written communication skills. • Microsoft Office suite/applicable software program(s) proficiency, and ability to learn new programs. Preferred Qualifications • Experience with utilization/quality program management. • Managed care experience. • Peer review experience. • Certified Professional in Healthcare Management (CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of America (CMSA) or other health care or management certification. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V #PJHS #LI-AC1

JOB SUMMARY: The Nurse Director ensures the delivery of safe, high-quality patient care for the Medical/Surgical unit. The Director is responsible 24 hours a day, with full accountability for the staffing and management of patient care, for providing professional nursing services in specified patient care areas, and the acquisition, development and utilization of resources including human, material and fiscal needed to meet those responsibilities. Coordinate scheduling of hospital nursing staff according to patient census and acuity. Handles the clerical and administrative management of the unit in an effective and efficient manner at all times. Acts as a creative leader combining nursing expertise, critical thinking and effective leadership and management skills to ensure that quality care is provided through satisfied and inspired professionals. Collaborates with Nurse Directors, hospital staff and physicians to achieve goals. Maintains accountability to County, State and Federal agencies as well as The Joint Commission for compliance with applicable laws, regulations and standards and for providing quality patient outcomes. EDUCATION, EXPERIENCE, TRAINING Active Registered Nurse licensed in the State of California with no restrictions, no actions and not in probation. BS degree in Nursing or other healthcare-related field, or equivalent combination of education and experience. Certification in specialty area preferred. MS degree in Healthcare -related field preferred. Clinical expertise in medical/surgical nursing that is normally acquired through five years of experience as staff nurse and/or charge nurse. Five years of progressive nursing administration experience required. Three years recent RN acute care experience. High level critical thinking and analytical skills to make management decisions at unit level and make recommendations for consideration on departmental issues. Interpersonal and management skills and knowledge of employee relation laws in order to deal with complex management problems and communicate with unit personnel, physicians, administrative personnel, a variety of other hospital personnel and community persons. Organizational skills, effective time management and delegation strategies including the ability to rapidly prioritize and adjust work flow according to changing unit needs. Well-developed skills in using computers. Experience in training and teaching others. Ability to be physically active, including seeing, hearing, speaking, sitting, standing, bending, squatting, twisting, pushing, pulling, lifting.

Providence Little Company of Mary is seeking a Physician Advisor/UM Medical Director to join a strong leadership team promoting high-value care in Torrance, California. This is an opportunity to facilitate and further develop strong collaborative and positive mutually supported relationships between the medical center and its physicians to improve clinical quality, resource utilization and increase value while maintaining and improving our mission outcomes. You will work closely with the physician leadership, the Director of Care Management, and executive leadership; in particular the CMO, CNO, and CFO to achieve these means. Other principal responsibilities of the role shall be to provide clinical expertise to Care Management in the form of strategic partnership as well as in the addressing of escalations that include admission status determinations, delays in discharge and the providing of clinical input for denial management. This is an opportunity to be on the forefront of healthcare leadership as part of one of the largest and strongest mission-driven medical organizations on the West Coast. Position Details & Compensation: + Monday to Friday schedule, no travel - must work on-site at PLCOM in Torrance + Compensation is between $325,000 and $380,000 per year + Full benefits including health, vision, dental, retirement, PTO, CME and more _The posted salary reflects the starting range of total compensation and may include productivity bonuses, incentives related to quality and performance, hospital/ED call stipends, extra shift incentives, and other forms of cash compensation as applicable to the position. In addition, providers typically receive a CME allowance and other benefits offered by their medical group employer. Please note that this salary range is provided in accordance with State law and is subject to variation due to the factors noted above._ Qualifications & Requirements: + MD or DO from accredited program required + 3+ years of medical group management experience required + Must have working knowledge of utilization management and review essential to operations management and to clinical improvement + Must have an understanding of the dynamics of health care industry and its effects on all stakeholders + Ability to develop and maintain strong, effective relationships with the medical staff, Board of Trustees, and hospital management required + Ability to effectively communicate with, motivate, and assist medical staff leadership to adhere to utilization management, clinical documentation, and other legal/regulatory requirements Where You'll Work Providence Little Company of Mary Medical Center Torrance has a 50-year legacy of excellence in this coastal south Los Angeles suburb and is one of six hospitals Providence operates in Southern California. Winner of Truven Health Analytics 100 Top Hospitals award three years in a row, Little Company of Mary offers cutting-edge technology and therapies in cardiac, surgical and neonatal care, all in a state-of-the-art facility just 2 miles from the beach. Where You'll Live Nestled in the South Bay area 25 miles southwest of downtown Los Angeles, Torrance is a diverse city with local eateries, outdoor parks, family-friendly neighborhoods and thriving high-tech industry. It is known for its hub of authentic Asian restaurants and supermarkets and easy access to cultural and sports venues. Torrance and the nearby Palos Verdes Peninsula are home to some of the best coastal golf courses and beaches in southern California. Who You'll Work For Providence is a nationally recognized, comprehensive healthcare organization spanning seven states with a universal mission - to provide compassionate care to all who need its services, especially the poor and vulnerable. Its 122,000-plus caregivers/employees (including 34,000 physicians) serve in 51 hospitals, more than 1,000 clinics and a comprehensive range of health and social services. Providence: One name, one family, one extraordinary health system. Check out our benefits page for more information. Equal Opportunity Employer including disability/veteran _Job ID Number: 30355_ _Facility Name: Providence Little Company of Mary Medical Center - Torrance_ _Location Name: Torrance_ _Brand Name: Providence_ _Provider Profession: Director_ _Medical Specialty: Not Applicable_ _Job Setting: Hospital, Medical Clinic_ _Type of Role: Clinical_ _Type of Role: Medical Director_ _Email: ******************************_ _Phone Number: **************_ _Schedule: Full Time_ _Compensation: $325,000 - $380,000 Per Year_ _CP: Yes_ _CB: Yes_ _J1: No_ _H1B: No_ Let's get in touch If you have questions about this specific job or others, I'm all ears. Send me a note and we'll be one step closer to the right opportunity. Sharon DiChiara Provider Recruiter ************** ****************************** Contact Me

LA County Programs provide a gender-responsive and trauma-informed environment, using evidence-based and best practices that recognize and account for the role that trauma frequently plays in the lives of the clients we serve. Our treatment and recovery services include withdrawal management, individual and group counseling, drug testing (if mandated), drug & alcohol education, recovery planning, case management, and relapse prevention. The LA County Addiction Medical Director is a member of the program leadership team and fosters teamwork, collaboration, and integration of all service areas. This position oversees care for clients at LA County residential and withdrawal management programs. The Addiction Medical Director provides direct clinical services, supervision, performance management, provides training, hires, and terminates clinical staff, and participates in a clinical committee that develops policies and procedures to ensure quality patient care and the orientation of new providers. In addition, this position oversees Advanced Practice Providers, provides input in performance appraisals, supervision, and peer review. The LA County Addiction Medical Director will have a set in-person schedule, primarily at the Pomona Residential program, but will also oversee each program with ad hoc presence as needed. KEY RESPONSIBILITIES Leadership Provides in-person leadership and presence at all LA county programs based on a set schedule and ad hoc as needed. Collaborates with VP of BHMS and SoCal Director of Addiction Medicine to provide leadership for integration of services between behavioral health and medical at LA County programs. Provides coaching mentoring and support to LA county providers. Participate in HR360 and program leadership meetings and activities. Represents HR360 and LA county programs in external meetings with the county, funders, CDCR, etc. as required. Champions high quality care, practice management, and reaching fiscal goals. Clinical Oversees and delivers care for patients suffering from substance use disorders and withdrawal management. Will provide withdrawal management and MAT services. Will achieve clinical productivity targets as set by agency standards for patient-facing providers. Ensure quality and efficient patient care by collaborating with the Nurse Manager and Program leadership team. Ensure that appropriate care is delivered to all patients. Work with VP of BH MS Services to ensure staff meet productivity requirements while ensuring high quality clinical care. Foster integration of services at the programs. Provide supervision and oversight of quality of care and provide clinical consultations for nursing, behavioral health, and medical providers. Orient new staff, monitor performance through peer review, chart audits, utilization review, and other processes. Respond to patient requests for information and assistance (e.g., form completion, prescription refills, etc.) in a timely manner. Provide oversight for Advanced Practice Providers , provide supervision, provide input in the clinical review, conduct performance appraisal, and peer review, and assist with hiring and termination of other providers and clinical staff. Participate in regular supervision meetings with medical providers. Be available for consultations when difficult or complex patients arise. Review a set number of charts for each provider; this number will vary based on experience and credentials of the provider and will be determined by the Medical Director. When certain forms or documents require a physician signature, review said forms with provider and execute signature if care is appropriate. Provide on-call after-hours availability as needed for medical issues only. Work evening and weekends as required. Administrative Participate in a monthly Clinical Committee meeting that creates and develops policies and procedures pertaining to HealthRIGHT 360's behavioral and medical care. Medical Director will report administratively to the VP of Behavioral Health Medical Services (VP of BHMS), who will be tasked with overseeing the implementation of P&Ps and workflows. Champion quality improvement efforts. Participate in peer reviews to improve quality of clinical services. Partner with the VP of BHMS in monitoring performance of the program and providers and work with leadership team to improve the quality and efficiency of care and service provided to patients. Provide clinical supervision for clinical staff such as reporting physicians, nurse practitioners, nurses, or psychiatric technicians. Provide input into performance appraisal, performance improvement plans, written warnings, and facilitate terminations. Attend, facilitate, and participate in meetings and training opportunities. Compliance Co-sign treatment plans and medical necessity determinations as required by funder requirements. Understand and ensure compliance with policies and procedures to manage risk. Ensure compliance with HIPAA, 42CFR regulations and all other funding mandates and licensing requirements. Ensure program staff, management, and other senior management are informed on quality-of-care concerns through regular reporting and/or team discussions. Documentation Collaborates with each caseload and other available internal and external resources to develop/maintain treatment plans, transition plans, progress notes and appropriate updates in support of the health and recovery needs of the patient. Maintain documentation in compliance with agency, HIPAA, 42CFR, and funder standards. Properly document all services provided and complete admission and discharge paperwork or process and required agency assessments in a timely manner and ensure that the golden thread is documented throughout the chart. Develop and assess effectiveness of individualized treatment plans and participant progress. Assist in ongoing maintenance of patient's charts and other related documentation. Ensure that all clinical documentation is completed in a timely and accurate manner and entered into the various electronic systems. And perform other duties as assigned. QUALIFICATIONS Education, Certification, or Licensure Graduation from an accredited M.D. or D.O. school. Board certified in Addiction Medicine or significant clinical experience in Addiction Medicine. Possession of a valid MD/DO license in CA. Possession of a valid Drug Enforcement Administration (DEA) certificate is required. Current BLS/ACLS certification or ability to obtain prior to hire. Experience Medication-Assisted Treatment (MAT) experience. Experience working with individuals with issues of substance abuse, mental health, criminal background, other potential barriers to economic self-sufficiency. Background Check and Other Requirements Must not be on active parole or probation. Must complete a background check and livescan. Must be fully vaccinated against COVID-19, including booster shot. Medical or religious exemptions available. Additional Commitment to maintaining CME and licensure requirements. Must be able to meet travel requirements related to job commute as necessary for onsite practice at various assigned locations.

About Our Clinic Beaumont Animal Hospital is a well-established veterinary hospital dedicated to providing exceptional care for pets in Beaumont, CA, and surrounding areas. We pride ourselves on offering high-quality medical services in a friendly and compassionate environment. Beaumont Animal Hospital | Best Veterinary Care in Beaumont,... Clinic Snapshot Practice type: General Practice Avg. daily patient volume: [16 /day] Support staff ratio: [2 : 1] Case mix: Wellness, Sick Pets, Surgery, Dentistry, Technology & equipment: Digital X-ray, Digital Dental, ultrasound, in-house labs Team culture: Collaborative, Supportive, and Skilled Team Total Rewards & How We Invest in You We believe great doctors deserve great rewards. $170k - $200k annual salary + production bonus Medical Director stipend DVM Long-Term Incentive (LTI) Cash Program - earn annual bonuses based on your production No negative accrual: We reward performance without penalizing you during slower periods Transparent production metrics and operational support to maximize earnings Generous CE allowance + paid licenses and professional dues Referral bonus program: Bring great talent to our network & get rewarded Flexible scheduling, strong work-life balance, and mentorship programs Relocation assistance and sign on bonuses available 401k retirement savings plan with company match What Makes Us Different Medical autonomy: Practice exceptional medicine and surgery with the full support of our medical systems and team. Robust support: Skilled techs, dedicated CSRs, and strong leadership presence. We believe thriving teams build thriving communities You'll have the tools, resources, and opportunities to grow your career Who You Are & How You'll Make a Difference You are a veterinarian who is: Passionate about patient care and long-term client relationships A collaborative teammate who thrives in a positive, supportive culture Committed to continuous growth and excellence Qualifications Doctor of Veterinary Medicine (DVM/VMD) or equivalent degree from an accredited university (required) Compassionate, client-centered approach to care Strong communication and client-education skills Strong Surgical skills Fun Things to Do Near Beaumont, CA: Beaumont Cherry Festival (During the summer) Oak Valley Golf Club Oak Glen Apple Orchards Desert Hills Premium Outlets Join Our Team: If you are a dedicated veterinarian looking to make a difference in the lives of pets and their owners, we would love to hear from you. Please submit your resume to me at ************************* #LI-SC1 At AmeriVet, we're committed to your growth, development, well-being, and success. We empower team members with the resources, support, and opportunities needed to thrive in their careers and make a lasting impact in our communities. Here's what you can expect when you join our team: Tailored development programs, mentorship, and career pathing to help you achieve your unique goals. Competitive pay, performance bonuses, 401(k) matching, and student loan assistance to foster your financial well-being. Health, dental, vision, life insurance, and mental health resources to support your overall well-being. Generous paid time off and holidays, because your personal time matters. A supportive, collaborative environment where everyone feels a sense of belonging. Please note: Any Benefits listed above apply to full-time employees. At AmeriVet, your unique skills and passion are celebrated, and every team member has the tools to thrive. Our people-focused approach is centered on helping you grow in your career while making a meaningful impact on the communities we serve.

Grow Healthy If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn't just welcomed - it's nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don't just serve our communities; we are an integral part of them. By raising the expectations of what a community clinic can deliver, we demonstrate our belief that quality care is for everyone. Our commitment to providing exceptional care, despite any challenges, goes beyond just a job; it's a calling that drives us forward every day. Job Overview The Associate Medical Director of Quality is responsible for collaborating in the overall direction, leadership, and oversight of the clinical quality and safety programs of AltaMed Services. The Associate Director assists the medical leadership in understanding, coordinating, and measuring the performance of internal and external quality and safety requirements and provides leadership in strengthening a quality culture where everyone is engaged and respected. The Associate Director leads initiatives that provide education, training, and continuous improvement methods for providers on Quality & Safety standards, resulting in an improvement in overall quality performance. In addition, the Associate Director partners with health plans and regulatory bodies, ensuring alignment with standards in clinical quality and safety, as well as serves as support to the Chief Quality Officer (CQO) in the representation of the critical governance committee, inclusive of the Quality Committee and the Board Quality Committee. Lastly, this role assists the CQO in addressing clinical, programmatic, and population management issues in collaboration with the other medical directors, as it relates to quality and safety. Minimum Requirements Board-certified physician. California License to practice medicine and a DEA License. Previous experience with computer-based systems and analytic software is strongly preferred. Electronic Medical records are preferred. Experience in statistical analysis and predictive analysis. A minimum requirement of a valid BLS certification or higher, following the American Heart Association (AHA) or the American Red Cross guidelines. Compensation $301,213.75 - $361,456.50 annually Compensation Disclaimer Actual salary offers are considered by various factors, including budget, experience, skills, education, licensure and certifications, and other business considerations. The range is subject to change. AltaMed is committed to ensuring a fair and competitive compensation package that reflects the candidate's value and the role's strategic importance within the organization. This role may also qualify for discretionary bonuses or incentives. Benefits & Career Development Medical, Dental and Vision insurance 403(b) Retirement savings plans with employer matching contributions Flexible Spending Accounts Commuter Flexible Spending Career Advancement & Development opportunities Paid Time Off & Holidays Paid CME Days Malpractice insurance and tail coverage Tuition Reimbursement Program Corporate Employee Discounts Employee Referral Bonus Program Pet Care Insurance Job Advertisement & Application Compliance Statement AltaMed Health Services Corp. will consider qualified applicants with criminal history pursuant to the California Fair Chance Act and City of Los Angeles Fair Chance Ordinance for Employers. You do not need to disclose your criminal history or participate in a background check until a conditional job offer is made to you. After making a conditional offer and running a background check, if AltaMed Health Service Corp. is concerned about a conviction directly related to the job, you will be given a chance to explain the circumstances surrounding the conviction, provide mitigating evidence, or challenge the accuracy of the background report.

What you can expect! Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience! The Medical Director of Hospital & Ancillary Relations serves as a physician advisor / dyad partner to other members of the Hospital and Ancillary Relations leadership team in providing clinical leadership and guidance toward operational and quality improvement activities aimed at achieving the strategic initiatives set forth by Plan administration as they relate to hospital and ancillary services. The Medical Director of Hospital and Ancillary Relations leverages their knowledge and experience in health care operations and team dynamics to effectively collaborate with health plan and provider leaders and departments, soliciting input and support in identifying and implementing practice activities and setting appropriate standards to improve care delivery within the hospital and ancillary setting. Commitment to Quality: The IEHP Team is committed to incorporate IEHP's Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation. Additional Benefits Perks IEHP is not only committed to healing and inspiring the human spirit of our Members; we also aim to match our Team Members with the same energy by providing prime benefits and more. CalPERS retirement 457(b) option with a contribution match Generous paid time off- vacation, holidays, sick State of the art fitness center on-site Medical Insurance with Dental and Vision Paid life insurance for employees with additional options Short-term, and long-term disability options Pet care insurance Flexible Spending Account - Health Care/Childcare Wellness programs that promote a healthy work-life balance Career advancement opportunities and professional development Competitive salary with annual merit increase Team bonus opportunities Key Responsibilities Identify clinical practice opportunities within business unit projects and activities and apply clinical and administrative skills to guide the department in implementing strategic, organizational and departmental improvements. Provide clinical leadership to implement, manage and achieve hospital and ancillary optimal care goals utilizing existing channels (i.e., Joint Operations Meetings, Inland Empire Alliance meetings, throughput and quality workgroups, etc.), and via development of new avenues for implementation of novel approaches to identified challenges and highlighting best practices. Develop relationships with internal and external clinical leadership teams and focuses on mutual goals to improve the quality of medical and ancillary services to advance optimal care (i.e., pediatric strategy, quality network implementation for hospitalist, hospice, post-acute services) and promote appropriate utilization of resources. Inform and educate hospital and ancillary clinicians about relevant changes in clinical best practices, regulatory mandates, and other relevant information to support the health plan's strategies (i.e., palliative care initiatives, peer review program expectations). Maintain an updated and expanded knowledge base on factors that affect hospital and ancillary services, and ensures that relevant information about social, medical, and fiscal issues are incorporated into IEHP policies, procedures, and strategies (i.e., All-Plan Letters, state and federal regulations). Organize, coordinate, monitor, and promote the activities of the contracted medical providers to help ensure that the quality and appropriateness of services meets community standards. This may include collaboration with departmental leadership to educate and train clinicians in standards of care (i.e., specialty-specific care, evidenced-based practices, infection control practices, etc.). Provide recommendations for research and development activities in strengthening quality improvement efforts for the medical providers in hospital and ancillary areas. (i.e., Hospitalist Pay for Performance program). Articulate the importance and mission of the work surrounding hospice and post-acute services (i.e., SNF, long-term care, home health) to the community; specifically, how these impact hospital care quality and throughput, and Member/patient experience. Participate in the development and delivery of educational programs geared towards improving the practice of clinicians including, but not limited to, physicians, mid-level providers, etc. in various settings. Leverage knowledge of clinical, regulatory, social, political, and economic factors to provide feedback, as appropriate, to legislators and public policy makers about existing and proposed laws and regulations impacting hospital and ancillary care services. (i.e., payment practices). Monitor and improve quality of care delivered by medical providers rendering care to IEHP Members via a quality assessment and performance improvement program that encourages self- evaluation, anticipates, and plans for change, and meets regulatory requirements. Utilize results of quality assessment and performance improvement program findings to: a. Update and improve contracts, the medical provider evaluation process, financial incentives (i.e., pay for performance or value-based care integration), policies, procedures, and practices. b. Suggest, seek approval for and operationalize performance improvement activities aimed at closing gaps related to network adequacy, adequate utilization of available services (i.e., palliative care) and/or elevation of care delivery via innovative approaches. c. Identify solutions to problems that utilize a collaborative approach, including integration efforts with hospital, ancillary and community resources and services. Ensure, with other Medical Directors as appropriate, that Hospital and Ancillary Service Medical Staff and Contracted Medical Providers are providing appropriate care for IEHP Members including but not limited to availability of qualified medical consultative staff and oversight of their medical staff quality performance. Collaborate with Health Services to hold practitioners accountable for their utilization management activities (admissions, and transfers, including related orders and contracted facility case mix), engagement in interdisciplinary teams, performance, and practice, including corrective actions and adequate documentation of patient care as needed. Review recovery audit denials and appeals inclusive of second level appeal letter, second level medical necessity review, and peer to peer reviews. Perform any other duties as required to ensure Health Plan operations and department business needs are successful. Qualifications Education & Requirements Five (5) years of post-residency or licensure experience in a recognized specialty that includes but is not limited to Family Medicine, Internal Medicine, Pediatrics, and Emergency Medicine Experience in quality, care coordination, utilization management in an inpatient, ACO or FQHC environment Strong product and program management experience, product delivery, product environments, and management consulting Preferred: At least three (3) years of administrative experience. Experience is in a variety of clinical settings including inpatient, outpatient practice, and community-based care settings Medical Degree in a clinically related field (e.g., MD, DO) from an accredited institution required Preferred: Additional Master's Degree (e.g., MS, MPH, MBA) from an accredited institution Possession of an active, unrestricted, and unencumbered Physician's and Surgeon's Certificate issued by the State of California Medical Board required (A physician certified in a state other than California may be employed prior to receipt of California certification provided that an application for a California physician and surgeon's certificate is filed in the state of California prior to date of appointment.) Key Qualifications Valid California Driver's License preferred Strong knowledge and understanding of: Medical practice and understanding of clinical operations in the hospital and ancillary setting Various regulatory bodies and setting-specific requirements, including DHCS, NCQA, CMS, TJC/DNV. Current trends in health care and clinical operations Administrative practices and procedures including but not limited to quality assessment and improvement, care coordination, utilization review, peer review, credentialing and risk management Rules regulations, policies, and standards related to managed care Principles of effective supervision and organization Methods, techniques, practices, principles, and literature in the broad field of medical sciences Overview of the highly specialized techniques, procedures, and equipment used in the medical or surgical specialties Excellent Word, Excel, and PowerPoint skills. Superb communication skills, including oral and written presentation. Strong leadership skills Proven ability to: Communicate difficult concepts in a concise, elegant, and effective ways to key stakeholders, including providers, to reach consensus Be a team player with an ability to build trust with internal and external stakeholders Educate and train Be compassionate Start your journey towards a thriving future with IEHP and apply TODAY! Work Model Location This position is on a hybrid work schedule. (Monday & Friday - remote, Tuesday - Thursday onsite in Rancho Cucamonga, CA.) Pay Range USD $246,355.20 - USD $380,000.00 /Yr.

JOB DESCRIPTION Job SummaryProvides medical oversight and expertise related to behavioral health and chemical dependency services, and assists with implementation of integrated behavioral health care programs within specific markets/regions. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties • Provides behavioral health oversight and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs and chemical dependency services - working closely with regional medical directors to standardize behavioral health utilization management policies and procedures to improve quality outcomes and decrease costs. • Facilitates behavioral health-related regional medical necessity reviews and cross coverage. • Standardizes behavioral health-related utilization management, quality, and financial goals across all lines of businesses. • Responds to behavioral health-related requests for proposal (RFP) sections and reviews behavioral health portions of state contracts. • Assists behavioral health medical director lead trainers in the development of enterprise-wide education on psychiatric diagnoses and treatment. • Provides second level behavioral health clinical reviews, peer reviews and appeals. • Supports behavioral health committees for quality compliance. • Implements behavioral health specific clinical practice guidelines and medical necessity review criteria. • Tracks all clinical programs for behavioral health quality compliance with National Committee for Quality Assurance (NCQA) and Centers for Medicare and Medicaid Services (CMS). • Assists with the recruitment and orientation of new psychiatric medical directors. • Ensures all behavioral health programs and policies are in line with industry standards and best practices. • Assists with new program implementation and supports for health plan in-source behavioral health services. Required Qualifications • At least 3 of relevant experience, including 2 years of medical practice experience in psychiatry/behavioral health, or equivalent combination of relevant education and experience. • Doctor of Medicine (MD) or Doctor of Osteopathy (DO). License must be active and unrestricted in state (NY) of practice. • Board Certification in Psychiatry. • Working knowledge of applicable national, state, and local laws and regulatory requirements affecting medical and clinical staff. • Ability to work cross-collaboratively within a highly matrixed organization. • Strong organizational and time-management skills. • Ability to multi-task and meet deadlines. • Attention to detail. • Critical-thinking and active listening skills. • Decision-making and problem-solving skills. • Strong verbal and written communication skills. • Microsoft Office suite/applicable software program(s) proficiency, and ability to learn new programs. Preferred Qualifications • Experience with utilization/quality program management. • Managed care experience. • Peer review experience. • Certified Professional in Healthcare Management (CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of America (CMSA) or other health care or management certification. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Be Well is located on the Be Well Orange County campus, which brings together mental health care services uniting public, private, academic, and faith-based organizations in a cooperative partnership that helps facilitate communication, bridge gaps, and eliminate barriers to care. The result is a more compassionate system of care that works better for everyone in the community. The 24/7/365 residential substance use disorder (SUD) treatment program provides 3.1, 3.3, and 3.5 ASAM levels of care for males and females, as well as 3.2 withdrawal management. There are 15 beds allocated for 3.1/3.5, 15 beds for 3.3and 12 beds for 3.2, for a total of 42 beds. The part-time (20 hours a week) Associate Medical Director is primarily responsible for the oversight and delivery of care. This is accomplished through the monitoring of clinical skills of providers and patient access to care, participation in the performance improvement process, assisting in the development of policies and procedures used to ensure quality patient care and the orientation of new providers. The Associate Medical Director is a member of the program leadership team and fosters teamwork, collaboration, and integration of all service areas. KEY RESPONSIBILITIES Responsibilities include oversight and delivery of care for patients suffering from substance use disorders and co-occurring psychiatry disease including withdrawal management. Other duties include: In conjunction with program leadership, creates, contributes to and implements policies pertaining to the HR360 behavioral and medical care. In collaboration with Nurse Manager, program leadership, regional leadership, and Medical Director works to ensure quality, efficient patient care. Provides full supervision in addition to clinical supervision and oversight for Advanced Practice Providers including entering into Collaborative Agreements with the Advanced Practice Provider, providing supervision and having input in the clinical review, performance appraisal, peer review and hiring and termination providers and clinical support staff. Provides supervision and oversight of quality of care among providers and ancillary staff in clinical areas. This includes being available for consultations. Supervises advanced practice providers: Participate in regular supervision meetings with medical providers. Be available for consultations when difficult or complex patients arise. Review a set number of charts for each provider; this number will vary based one experience and credentials of the provider and will be determined by the Medical Director. When certain forms or documents require a physician signature, review said forms with provider and execute signature if care is appropriate. Strategize how best to allocate resources to support expanded services. Ensures that appropriate care is delivered to all patients; from withdrawal management and Residential Treatment Center (RTC) to Intensive Out Patient (IOP) and other outpatient services. Fosters integration of services at the programs. Champions Quality Improvement efforts. Ensures patient access to care by monitoring provider productivity targets. In conjunction with the Medical Director supports providers in attaining goals through practice management or other support. Work with Nurse Manager to ensure adequate productivity of nursing staff as set forth by the organization. Work with Medical Director to ensure adequate productivity of providers (MD/DO/NP/PA) as set forth by the organization. Is an active member of the program leadership team. Actively fosters collaboration and furthers integration efforts among service areas. Clinical Staff Direction Responsibilities: Reviews employee performance provides feedback and makes recommendations for individual performance improvement and development for medical providers and other staff. Performs annual performance appraisal of providers. Orients new physicians and advanced practice providers; monitors performance during initial employment and thereafter through peer review, chart audits, utilization review and other processes. Responds to patient requests for information and assistance (e.g., form completion, prescription refills, etc.) in a timely manner. Provides on-call after-hours availability as requested by the Medical Director. Works evening and weekends as required. Works directly with the Nurse Manager to provide competent care and provides oversight of nursing staff. Provides withdrawal management services, MAT, as well as behavioral and Incidental Medical Services related medical and psychiatric care in the RTC and IOP settings. Agency Development/Support Responsibilities: Attends and participates in Integrated Team Meetings. Able to precept for medical students, residents, and fellows -educate, train, and supervise volunteers when necessary. Supports and actively participates in clinical performance improvement initiatives. Participates in on going internal and/or external leadership development opportunities. Administrative Responsibilities: Participates in Peer Reviews to improve quality of clinical services. Provides clinical leadership to the program in collaboration with the divisional director and managing director. Monitors the performance of the program and works with the divisional director and managing director to improve the quality and efficiency of care and service provided to participants. Provides training and consultation to treatment staff. Attends required training and meetings. Supervises nurse practitioners and licensed vocational nurse or licensed psychiatric technicians. Responsible for all performance management including performance improvement plans, formal written warning notices and terminations of all direct reports as needed and in consultation with Divisional Director and/or Managing Director. Ensure that program's physicians are adequately trained to perform other physician duties, if applicable. Compliance responsibilities: Compliance responsibilities include co-signing treatment plans and medical necessity determinations as required by funder requirements. Understands and ensures compliance with policies and procedures to manage risk. Ensures compliance with HIPAA, 42CFR regulations and all other funding mandates and licensing requirements. Ensures program staff, management, and other senior management are informed on quality-of-care concerns through regular reporting and/or team discussions. Develop protocols and work in collaboration with Quality Assurance and management team to develop policies regarding medication assisted treatment. Training responsibilities: Training responsibilities include developing and conducting training in clinical topics related to the delivery of medication services. Ensuring all direct reports are properly trained and updated on HIPAA regulations and compliance as well as any other ongoing compliance and regulatory requirements. Documentation Responsibilities: Collaborates with each caseload participant and other available internal and external resources to develop/maintain treatment plans, transition plans, progress notes and appropriate updates in support of the health and recovery needs of the participant. Maintain documentation in compliance with agency, HIPAA, 42CFR, and funder standards. Properly documents all services provided and completes admission and discharge paperwork/process and required agency assessments in timely manner and ensure that the golden thread is documented throughout the chart. Develop and assess effectiveness of individualized treatment plans and participant progress. Assist in ongoing maintenance of participants' charts and other related documentation. Ensure that all clinical documentation is completed in a timely and accurate manner and entered into the various electronic systems. EDUCATION AND KNOWLEDGE, SKILLS AND ABILITIES QUALIFICATIONS: Education and Experience Required: A valid and unrestricted California Physician's License (MD or DO) with a specialty in psychiatry and / or addiction medicine Sub-specialty in Addiction Medicine or significant clinical experience in Addiction Medicine Valid DEA certificate, X-waiver, 275 cap. Knowledge of third-party payer requirements, California practice guidelines and malpractice laws, -Title 22, Bureau of Primary Care and state funding sources preferred, and 42 CFR/HIPAA. Will maintain required CME and other professional requirements to maintain the above. Experience serving adults with chronic medical conditions and co-occurring severe mentally illness and substance use challenges A minimum 5 years post-licensure experience in direct participant care, ideally in intensive psychiatric and substance use treatment settings Desired: Board Certification in Addiction Medicine Knowledge Required: Culturally competent and able to work with a diverse population Strong proficiency with Microsoft Office applications, specifically Word Outlook and internet applications Experience working successfully with issues of substance abuse, mental health, and other potential barriers to economic self sufficiency Knowledge and respect of all confidentiality issues. Knowledge of and experience with providing culturally competent and trauma informed services

Grow Healthy If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn't just welcomed - it's nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don't just serve our communities; we are an integral part of them. By raising the expectations of what a community clinic can deliver, we demonstrate our belief that quality care is for everyone. Our commitment to providing exceptional care, despite any challenges, goes beyond just a job; it's a calling that drives us forward every day. Job Overview The Associate Medical Director of Quality is responsible for collaborating in the overall direction, leadership, and oversight of the clinical quality and safety programs of AltaMed Services. The Associate Director assists the medical leadership in understanding, coordinating, and measuring the performance of internal and external quality and safety requirements and provides leadership in strengthening a quality culture where everyone is engaged and respected. The Associate Director leads initiatives that provide education, training, and continuous improvement methods for providers on Quality & Safety standards, resulting in an improvement in overall quality performance. In addition, the Associate Director partners with health plans and regulatory bodies, ensuring alignment with standards in clinical quality and safety, as well as serves as support to the Chief Quality Officer (CQO) in the representation of the critical governance committee, inclusive of the Quality Committee and the Board Quality Committee. Lastly, this role assists the CQO in addressing clinical, programmatic, and population management issues in collaboration with the other medical directors, as it relates to quality and safety. Minimum Requirements Board-certified physician. California License to practice medicine and a DEA License. Previous experience with computer-based systems and analytic software is strongly preferred. Electronic Medical records are preferred. Experience in statistical analysis and predictive analysis. A minimum requirement of a valid BLS certification or higher, following the American Heart Association (AHA) or the American Red Cross guidelines. Compensation $301,213.75 - $361,456.50 annually Compensation Disclaimer Actual salary offers are considered by various factors, including budget, experience, skills, education, licensure and certifications, and other business considerations. The range is subject to change. AltaMed is committed to ensuring a fair and competitive compensation package that reflects the candidate's value and the role's strategic importance within the organization. This role may also qualify for discretionary bonuses or incentives. Benefits & Career Development Medical, Dental and Vision insurance 403(b) Retirement savings plans with employer matching contributions Flexible Spending Accounts Commuter Flexible Spending Career Advancement & Development opportunities Paid Time Off & Holidays Paid CME Days Malpractice insurance and tail coverage Tuition Reimbursement Program Corporate Employee Discounts Employee Referral Bonus Program Pet Care Insurance Job Advertisement & Application Compliance Statement AltaMed Health Services Corp. will consider qualified applicants with criminal history pursuant to the California Fair Chance Act and City of Los Angeles Fair Chance Ordinance for Employers. You do not need to disclose your criminal history or participate in a background check until a conditional job offer is made to you. After making a conditional offer and running a background check, if AltaMed Health Service Corp. is concerned about a conviction directly related to the job, you will be given a chance to explain the circumstances surrounding the conviction, provide mitigating evidence, or challenge the accuracy of the background report.

Replies within 24 hours Benefits: * Competitive salary * Flexible schedule * Opportunity for advancement The Medical Director for the Dermatology Office provides clinical leadership, medical oversight, and ensures the delivery of safe, high-quality, evidence-based dermatologic care. This role is responsible for supervising clinical providers, establishing medical protocols, ensuring regulatory compliance, and supporting the overall clinical and operational success of the practice. Key Responsibilities Clinical Oversight * Provide medical supervision and oversight of dermatology providers (MDs, PAs, NPs, MAs, aestheticians as applicable). * Establish, review, and update clinical protocols, treatment guidelines, and standard operating procedures. * Ensure all dermatologic services are delivered in accordance with current best practices and evidence-based medicine. * Be available for clinical consultation, case review, and escalation of complex or high-risk cases. Quality & Compliance * Ensure compliance with all federal, state, and local regulations, including scope of practice, licensing, and supervision requirements. * Maintain compliance with HIPAA, OSHA, infection control, and patient safety standards. * Participate in quality assurance, peer review, and risk management activities. * Review and approve clinical documentation, consent forms, and patient education materials as needed. Leadership & Collaboration * Serve as the clinical leader and liaison between medical staff and practice management. * Support recruitment, onboarding, and training of clinical providers. * Foster a culture of professionalism, patient-centered care, and clinical excellence. * Participate in staff meetings, clinical trainings, and performance improvement initiatives. Business & Operational Support * Provide input on service offerings, clinical workflows, and new dermatologic treatments or technologies. * Support credentialing, payer enrollment, and chart review requirements as needed. * Assist with audits, inspections, and payer reviews when applicable. * Collaborate with leadership on strategic planning and growth initiatives. Qualifications Required * MD or DO with board certification or board eligibility in Dermatology. * Active, unrestricted medical license in the state of practice. * DEA registration (if applicable). * Minimum of 3-5 years of clinical dermatology experience. * Experience supervising or collaborating with advanced practice providers. Preferred * Prior experience as a Medical Director or in a leadership role. * Experience in outpatient dermatology, cosmetic dermatology, or med spa settings. * Strong knowledge of regulatory and compliance standards. * Excellent communication, leadership, and organizational skills. Physical & Work Requirements * Ability to perform clinical and administrative duties. * May require on-site presence, remote availability, or a hybrid model depending on practice needs. Compensation: $2,000.00 per month PS: It's All About You! American Family Care has pioneered the concept of convenient, patient-centric healthcare. Today, with more than 250 clinics and 800 in-network physicians caring for over 6 million patients a year, AFC is the nation's leading provider of urgent care, accessible primary care, and occupational medicine. Ranked by Inc. magazine as one of the fastest-growing companies in the U.S., AFC's stated mission is to provide the best healthcare possible, in a kind and caring environment, while respecting the rights of all patients, in an economical manner, at times and locations convenient to the patient. If you are looking for an opportunity where you can make a difference in the lives of others, join us on our mission. We invite you to grow with us and experience for yourself the satisfying and fulfilling work that the healthcare industry provides. Please note that a position may be for a company-owned or franchise location. Each franchise-owned and operated location recruits, hires, trains, and manages their own employees, sets their own employment policies and procedures, and provides compensation and benefits determined by that franchise owner. Company-owned locations provide a comprehensive benefits package including medical, dental, vision, disability, life insurance, matching 401(k), and more. We are an Equal Opportunity Employer.

What you can expect! Find joy in serving others with IEHP! We welcome you to join us in "healing and inspiring the human spirit" and to pivot from a "job" opportunity to an authentic experience! The Medical Director of Hospital & Ancillary Relations serves as a physician advisor / dyad partner to other members of the Hospital and Ancillary Relations leadership team in providing clinical leadership and guidance toward operational and quality improvement activities aimed at achieving the strategic initiatives set forth by Plan administration as they relate to hospital and ancillary services. The Medical Director of Hospital and Ancillary Relations leverages their knowledge and experience in health care operations and team dynamics to effectively collaborate with health plan and provider leaders and departments, soliciting input and support in identifying and implementing practice activities and setting appropriate standards to improve care delivery within the hospital and ancillary setting. Commitment to Quality: The IEHP Team is committed to incorporate IEHP's Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation. Perks IEHP is not only committed to healing and inspiring the human spirit of our Members; we also aim to match our Team Members with the same energy by providing prime benefits and more. * CalPERS retirement * 457(b) option with a contribution match * Generous paid time off- vacation, holidays, sick * State of the art fitness center on-site * Medical Insurance with Dental and Vision * Paid life insurance for employees with additional options * Short-term, and long-term disability options * Pet care insurance * Flexible Spending Account - Health Care/Childcare * Wellness programs that promote a healthy work-life balance * Career advancement opportunities and professional development * Competitive salary with annual merit increase * Team bonus opportunities Education & Requirements * Five (5) years of post-residency or licensure experience in a recognized specialty that includes but is not limited to Family Medicine, Internal Medicine, Pediatrics, and Emergency Medicine * Experience in quality, care coordination, utilization management in an inpatient, ACO or FQHC environment * Strong product and program management experience, product delivery, product environments, and management consulting * Preferred: At least three (3) years of administrative experience. Experience is in a variety of clinical settings including inpatient, outpatient practice, and community-based care settings * Medical Degree in a clinically related field (e.g., MD, DO) from an accredited institution required * Preferred: Additional Master's Degree (e.g., MS, MPH, MBA) from an accredited institution * Possession of an active, unrestricted, and unencumbered Physician's and Surgeon's Certificate issued by the State of California Medical Board required (A physician certified in a state other than California may be employed prior to receipt of California certification provided that an application for a California physician and surgeon's certificate is filed in the state of California prior to date of appointment.) Key Qualifications * Valid California Driver's License preferred * Strong knowledge and understanding of: * Medical practice and understanding of clinical operations in the hospital and ancillary setting * Various regulatory bodies and setting-specific requirements, including DHCS, NCQA, CMS, TJC/DNV. * Current trends in health care and clinical operations * Administrative practices and procedures including but not limited to quality assessment and improvement, care coordination, utilization review, peer review, credentialing and risk management * Rules regulations, policies, and standards related to managed care * Principles of effective supervision and organization * Methods, techniques, practices, principles, and literature in the broad field of medical sciences * Overview of the highly specialized techniques, procedures, and equipment used in the medical or surgical specialties * Excellent Word, Excel, and PowerPoint skills. Superb communication skills, including oral and written presentation. Strong leadership skills * Proven ability to: * Communicate difficult concepts in a concise, elegant, and effective ways to key stakeholders, including providers, to reach consensus * Be a team player with an ability to build trust with internal and external stakeholders * Educate and train * Be compassionate Start your journey towards a thriving future with IEHP and apply TODAY! Pay Range * $246,355.20 USD Annually - $380,000.00 USD Annually

Benefits: * Competitive salary * Flexible schedule * Opportunity for advancement The Medical Director for the Dermatology Office provides clinical leadership, medical oversight, and ensures the delivery of safe, high-quality, evidence-based dermatologic care. This role is responsible for supervising clinical providers, establishing medical protocols, ensuring regulatory compliance, and supporting the overall clinical and operational success of the practice. Key Responsibilities Clinical Oversight * Provide medical supervision and oversight of dermatology providers (MDs, PAs, NPs, MAs, aestheticians as applicable). * Establish, review, and update clinical protocols, treatment guidelines, and standard operating procedures. * Ensure all dermatologic services are delivered in accordance with current best practices and evidence-based medicine. * Be available for clinical consultation, case review, and escalation of complex or high-risk cases. Quality & Compliance * Ensure compliance with all federal, state, and local regulations, including scope of practice, licensing, and supervision requirements. * Maintain compliance with HIPAA, OSHA, infection control, and patient safety standards. * Participate in quality assurance, peer review, and risk management activities. * Review and approve clinical documentation, consent forms, and patient education materials as needed. Leadership & Collaboration * Serve as the clinical leader and liaison between medical staff and practice management. * Support recruitment, onboarding, and training of clinical providers. * Foster a culture of professionalism, patient-centered care, and clinical excellence. * Participate in staff meetings, clinical trainings, and performance improvement initiatives. Business & Operational Support * Provide input on service offerings, clinical workflows, and new dermatologic treatments or technologies. * Support credentialing, payer enrollment, and chart review requirements as needed. * Assist with audits, inspections, and payer reviews when applicable. * Collaborate with leadership on strategic planning and growth initiatives. Qualifications Required * MD or DO with board certification or board eligibility in Dermatology. * Active, unrestricted medical license in the state of practice. * DEA registration (if applicable). * Minimum of 3-5 years of clinical dermatology experience. * Experience supervising or collaborating with advanced practice providers. Preferred * Prior experience as a Medical Director or in a leadership role. * Experience in outpatient dermatology, cosmetic dermatology, or med spa settings. * Strong knowledge of regulatory and compliance standards. * Excellent communication, leadership, and organizational skills. Physical & Work Requirements * Ability to perform clinical and administrative duties. * May require on-site presence, remote availability, or a hybrid model depending on practice needs. Compensation: $2,000.00 per month PS: It's All About You! American Family Care has pioneered the concept of convenient, patient-centric healthcare. Today, with more than 250 clinics and 800 in-network physicians caring for over 6 million patients a year, AFC is the nation's leading provider of urgent care, accessible primary care, and occupational medicine. Ranked by Inc. magazine as one of the fastest-growing companies in the U.S., AFC's stated mission is to provide the best healthcare possible, in a kind and caring environment, while respecting the rights of all patients, in an economical manner, at times and locations convenient to the patient. If you are looking for an opportunity where you can make a difference in the lives of others, join us on our mission. We invite you to grow with us and experience for yourself the satisfying and fulfilling work that the healthcare industry provides. Please note that a position may be for a company-owned or franchise location. Each franchise-owned and operated location recruits, hires, trains, and manages their own employees, sets their own employment policies and procedures, and provides compensation and benefits determined by that franchise owner. Company-owned locations provide a comprehensive benefits package including medical, dental, vision, disability, life insurance, matching 401(k), and more. We are an Equal Opportunity Employer.