Patient relations director jobs near me - 578 jobs

Abbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 114,000 colleagues serve people in more than 160 countries. Working at Abbott At Abbott, you can do work that matters, grow, and learn, care for yourself and your family, be your true self, and live a full life. You'll also have access to: Career development with an international company where you can grow the career you dream of. Employees can qualify for free medical coverage in our Health Investment Plan (HIP) PPO medical plan in the next calendar year. An excellent retirement savings plan with high employer contribution Tuition reimbursement, the Freedom 2 Save student debt program and FreeU education benefit - an affordable and convenient path to getting a bachelor's degree A company recognized as a great place to work in dozens of countries around the world and named one of the most admired companies in the world by Fortune. A company that is recognized as one of the best big companies to work for as well as a best place to work for diversity, working mothers, female executives, and scientists. The Opportunity Abbott Heart Failure (HF) delivers devices for patients living with heart failure in the areas of hemodynamic monitoring and mechanical circulatory support. Medical affairs of Abbott HF is seeking to hire a director who will join a team of medical specialist dedicated to all medical aspects of safe and effective device heart failure treatment. The director will report to the Chief Medical Officer. The Director of Medical Affairs will provide daily business operations support related to product development and clinical research, product quality, compliance, commercial/marketing activities and customer interactions. The director assists the Chief Medical Officer in being medical representative of Abbott HF to external regulatory agencies and professional societies. What You'll Work On The Medical Director Develops medical opinions, medical platform documents and Health Hazard Assessments. Provides medical input for promotional and commercial activities as requested. Serves as medical representative on Risk Evaluation teams. Assists investigation teams by providing medical input as needed. Responsible for updating medical affairs procedural documents and submitting change requests when needed. Provides medical support for MDR reporting when needed. Provides initial medical input for quality/regulatory customer communications, technical bulletins and quality directives. Engages with direct customer interactions with medical content as needed. Regionally responsible for Investigator Initiated Study and Research Grant programs. Provides input or content to professional education activities. Responsible for engaging in and documenting off-label discussions. Assists the Chief Medical Officer in KOL and professional society engagement. Provides medical input to new product development An MD is strongly preferred for this role, but a PhD in a relevant area would be considered. A minimum of 5 years of clinical experience including in CV medicine would be clinical research, including interpretation and presentation would be expected. Strong presentation skills required. The role is remote (US-based) Up to 70 % travel should be expected. APPLY NOW Enjoy a competitive base salary plus exciting bonus opportunities and long-term incentives designed to recognize your success. Learn more about our health and wellness benefits, which provide the security to help you and your family live full lives: ********************** Follow your career aspirations to Abbott for diverse opportunities with a company that can help you build your future and live your best life. Abbott is an Equal Opportunity Employer, committed to employee diversity. Connect with us at *************** on Facebook at *********************** and on Twitter @AbbottNews and @AbbottGlobal #J-18808-Ljbffr

Permanent Associate Medical Director Board Certified in Family Medicine / Internal Medicine FQHC Setting What we Offer: Schedule: M- F 8am to 5pm, No Weekends Competitive Pay: $250k to $270k. depends on experience Sign On Bonus: $30,000 Full Benefits Package - Medical, dental, vision, disability & life insurance. 401(k). What the Associate Medical Director will Do: 80% Clinical / 20% Administration Supervise and coach fellow providers in how to provide excellent primary care / urgent care and community care This is a FQHC setting must be comfortable with Community Medicine Partake in leadership meeting and also act as an ambassador to community based organizations, hospitals, and payers Requirements of the Associate Medical Director: 5+ Years clinical experience / Administrative leadership experience needed Must have 2 -3 recent years experience in primary care medicine Active and unrestricted medical or nursing license in the state required Background in working for a clinic or community based inpatient setting a plus Must be ok prescribing opioids

A leading biopharmaceutical company is seeking a Senior Director for Medical Affairs to lead initiatives focused on liver diseases. The ideal candidate should have substantial clinical experience in hepatology and a commitment to scientific excellence. This remote position requires strategic collaboration and contributions to research efforts to improve liver care outcomes. Strong leadership and communication skills are essential for engaging diverse healthcare professionals in clinical discussions. #J-18808-Ljbffr

A global connectivity solutions provider is seeking a Channel Sales Manager in Chicago. The role involves driving revenue growth through partnerships and managing day-to-day relationships with Technology Solution Distributors. Candidates should have 5-8 years of sales experience, preferably in telecommunications or enterprise technology, with strong communication and relationship-building skills. This position offers a competitive health care plan, 401k retirement plan, and the option to work from home. #J-18808-Ljbffr

A leading global connectivity provider is seeking a Channel Sales Manager to enhance revenue growth through established partnerships. The ideal candidate will have 5-8 years in sales, focusing on channel sales management, and will be responsible for managing partner relationships to maximize sales effectiveness. Strong skills in Salesforce and a background in telecommunications or networking technology are required. This role offers competitive benefits including health care and a retirement plan. Remote work options are available. #J-18808-Ljbffr

JAG Healthcare Marion is now scheduling RN/DON interviews as we are searching for our next long-term Director of Nursing (DON). JAG Healthcare Marion is seeking a strong, energetic Director of Nursing (DON) to work alongside their long-time Administrator to help maintain the excellent care culture that is established there. The Director of Nursing (DON) should be a compassionate RN who has at least five years of experience as a Director of Nursing or in a comparable position. Recognizing that there is much opportunity in our healthcare employment market for potential applicants, we are seeking candidates interested in employment stability, flexible scheduling, and the desire to secure a long-term employment opportunity. Being a smaller facility, there is a balance in the workload and exceptional patient care ratios. Leadership staff are expected to lead by example and be team-oriented to ensure the highest level of quality care and service can be delivered to our residents. JAG Healthcare Marion has only 45 beds, giving it a homelike feel for our residents. This quaint environment also provides our nurses the opportunity to spend meaningful time with their residents without rushing from one room to the next. This is one of the most common positive comments that we hear from nurses coming from larger healthcare facilities. If you are looking for a rewarding job as a Director of Nursing (DON) that allows you to build meaningful connections with residents while improving their quality of life, this job could be for you!. Skills & Responsibilities (include but not limited to): Direct, oversee, coordinate & evaluate nursing care services provided to the residents. Emphasis on education and staff development to grow and develop the nursing team Ensuring compliance with all State & Federal guidelines. Ensuring all confidentiality and privacy rights of residents are observed & enforced. Overseeing State Survey complaints, investigations, and resolutions. Develop and enforce policies aiming for legal compliance and high-quality standards. Develop objectives and long-term goals for the department. Guide staffing procedures. Excellent ability to lead and develop personnel. Willingness for continual education to keep up with changing standards in nursing administration. Exceptional communication and problem-solving skills, with a focus on customer service. Strong focus on Quality Assurance and Performance Improvement Team-oriented with the ability to work in a collaborative interdisciplinary setting Requirements for the position include: Licensed as a Registered Nurse (RN) in the State of Ohio and in good standing with the Board of Nursing. Must be familiar with and be able to follow all established Federal, State and Local rules, regulations, and guidelines. Must understand and be able to implement and follow the facility policy/procedure. Proven ability to lead a clinical team to successful clinical outcomes. Minimum of 5 years DON experience, or comparable position (required) Minimum of 5 years of acute care, long-term care, or geriatric supervisor and management experience in a Medicaid/Medicare certified facility (required). Experience working with cognitive deficits and behavioral health care (plus). Successful completion of the Infection Preventionist Training (preferred, but willing to assist with certification) Strong focus on inventory and supply chain management At JAG Healthcare, we offer a homelike family family-oriented atmosphere, striving to create a lifetime of balance for our residents, employees, and the communities in which we serve .

Site: Mass General Brigham Incorporated Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. Job Summary Mass General Brigham Health Plan UM Medical Director Qualifications Education: MD or DO required Licenses and Credentials: Physician - Massachusetts active full license required Experience: 5+ years of Health Plan UM experience at least 5 years of clinical practice experience Knowledge, Skills and Abilities: Utilization Management experience Excellent written and oral communications skills Proficient in basic computer skills, use of EHR's, digital tools Multitasking abilities Adaptable to change due to business growth Job Description: Handles utilization management initial determinations, appeals and grievances within the scope of their expertise as defined by Medicare, MassHealth, NCQA and the Division of Insurance and within the compliance requirements of key regulatory and accreditation entities Use CMS, state and internal medical necessity policies to guide MN determinations Complete peer to peer case discussions with requesting providers as assigned Refer to IRO/external review if specialist match or expertise is needed Interact, communicate and collaborate with network and community physicians, hospital leaders and other vendors regarding care and services for enrollees Monitors performance metrics to identify areas for continuous improvement and ensure compliance Establishes and maintains positive relationships with colleagues and customers and gains their trust and respect Ensure diversity, equity and inclusion are integrated as a guiding principle Other duties as assigned with or without accommodation Additional Job Details (if applicable) Primarily remote position M-F 830-5pm EST Ensures that all assigned work is completed within regulatory timelines Checks and addresses assigned work queues, email, Teams messages during assigned work hours Remote Type Remote Work Location 399 Revolution Drive Scheduled Weekly Hours 0 Employee Type Regular Work Shift Day (United States of America) EEO Statement: Balance Sheet Cost Centers is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at **************. Mass General Brigham Competency Framework At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.

Join the team leading the next evolution of virtual care. At Teladoc Health, you are empowered to bring your true self to work while helping millions of people live their healthiest lives. Here you will be part of a high-performance culture where colleagues embrace challenges, drive transformative solutions, and create opportunities for growth. Together, we're transforming how better health happens. Summary of Position Teladoc Health is seeking an experienced physician to serve as Medical Director, Cardiometabolic Clinical Care Model Design and Client Engagement. This physician leader will serve in a highly cross-functional role instrumental in shaping the future of cardiometabolic care at Teladoc Health, particularly within our U.S. Group Health Business, advancing clinical excellence across existing chronic condition management solutions while building and scaling novel approaches. This role will continue to champion seamless integration of cardiometabolic care across our expansive ecosystem of virtual primary care, urgent care, mental health, expert medical/specialty care, and more. This is an individual contributor leadership position requiring strong clinical expertise in cardiometabolic care and the ability to work strategically in the complex and rapidly evolving virtual care/digital health space. Success in this role requires close cross-functional collaboration with diverse stakeholders to enhance care delivery models, achieve best-in-class clinical outcomes, and optimize return on investment. The candidate will support value-based care partnerships and drive clinical research to strengthen the evidence base for virtual cardiometabolic care. Additionally, this physician leader must be able to translate these efforts into client-facing strategies, partnering with employers and payers to help them understand and achieve better health outcomes for their populations. Essential Duties and Responsibilities Serve as the clinical lead for designing cardiometabolic care models across new and existing capabilities within the U.S. Group Health business. Lead clinical and cross-functional teams to design, pilot, and scale innovative integrated cardiometabolic care models, working closely with front-line providers and care teams. Translate population health data and risk stratification into actionable program strategies. Define success metrics-including clinical outcomes and financial ROI-and develop strategies for sustained impact. Work closely with internal teams-including sales, marketing, and client-facing groups-providing clinical expertise for key presentations and client discussions. Represent the organization externally on topics related to chronic condition management and cardiometabolic care innovation. Develop and refine chronic condition management frameworks, measures, and reporting aligned with the Institute for Healthcare Improvement Quadruple Aim and Institute of Medicine quality domains: safety, effectiveness, patient-centeredness, efficiency, timeliness, and equity. Co-lead formal quality improvement projects using the Model for Improvement with a focus on process and outcome metrics and leveraging statistical process control (SPC) where appropriate. Partner with our Clinical Research team to generate evidence and insights for white papers and peer-reviewed publications demonstrating the impact of our cardiometabolic solutions. The time spent on each responsibility reflects an estimate and is subject to change dependent on business needs. Supervisory Responsibilities No Required Qualifications MD/DO in Internal Medicine, Family Medicine, or a cardiometabolic specialty; active medical license preferred At least 5+ years of post-residency or fellowship clinical experience Experience in virtual care, digital health, or healthcare technology, with the ability to adapt to rapid change and ambiguity. Demonstrated expertise in delivering evidence-based clinical care model design, clinical quality improvement, outcome measurement. Exemplary written and verbal communication skills, including the ability to explain complex clinical concepts to non-clinical audiences. Proven ability to collaborate effectively across clinical and non-clinical teams, including operations, product, engineering, marketing, commercial, and other functions in a highly matrixed environment. Strong prioritization, time management, and organizational skills, with meticulous attention to detail. Ability to thrive in fast-paced, dynamic environments with multiple competing priorities and deadlines. Preferred Qualifications Experience in dedicated virtual care/digital health organizations focused on cardiometabolic conditions. MBA/MPH and/or advanced quality improvement training preferred. Demonstrated experience delivering virtual care, particularly in primary care and cardiometabolic management beyond the COVID-19 pandemic. Expertise in value-based care delivery with track record of maximizing clinical outcomes while managing total cost of care. Required license or credential needed to perform job: MD/DO The above qualifications, knowledge, experience, and/or background are expected but not required for this role. Work Environment ☐ Office ☒ Remote ☐ Hybrid (Office & Remote) Travel: ≥10% Travel percentage reflects an estimate and is subject to change dependent on business needs. The base salary range for this position is $210,000 - $240,000. In addition to a base salary, this position is eligible for a performance bonus and benefits (subject to eligibility requirements) listed here: Teladoc Health Benefits 2026. Total compensation is based on several factors including, but not limited to, type of position, location, education level, work experience, and certifications. This information is applicable for all full-time positions. As part of our hiring process, we verify identity and credentials, conduct interviews (live or video), and screen for fraud or misrepresentation. Applicants who falsify information will be disqualified. Teladoc Health will not sponsor or transfer employment work visas for this position. Applicants must be currently authorized to work in the United States without the need for visa sponsorship now or in the future. Why join Teladoc Health? Teladoc Health is transforming how better health happens. Learn how when you join us in pursuit of our impactful mission. Chart your career path with meaningful opportunities that empower you to grow, lead, and make a difference. Join a multi-faceted community that celebrates each colleague's unique perspective and is focused on continually improving, each and every day. Contribute to an innovative culture where fresh ideas are valued as we increase access to care in new ways. Enjoy an inclusive benefits program centered around you and your family, with tailored programs that address your unique needs. Explore candidate resources with tips and tricks from Teladoc Health recruiters and learn more about our company culture by exploring #TeamTeladocHealth on LinkedIn. As an Equal Opportunity Employer, we never have and never will discriminate against any job candidate or employee due to age, race, religion, color, ethnicity, national origin, gender, gender identity/expression, sexual orientation, membership in an employee organization, medical condition, family history, genetic information, veteran status, marital status, parental status, or pregnancy). In our innovative and inclusive workplace, we prohibit discrimination and harassment of any kind. Teladoc Health respects your privacy and is committed to maintaining the confidentiality and security of your personal information. In furtherance of your employment relationship with Teladoc Health, we collect personal information responsibly and in accordance with applicable data privacy laws, including but not limited to, the California Consumer Privacy Act (CCPA). Personal information is defined as: Any information or set of information relating to you, including (a) all information that identifies you or could reasonably be used to identify you, and (b) all information that any applicable law treats as personal information. Teladoc Health's Notice of Privacy Practices for U.S. Employees' Personal information is available at this link .

The Regional Medical Affairs Director (RMAD) is a member of a field-based team which is an extension of the US Regional Medical Affairs organization and is responsible for developing and enhancing professional relationships with specified key thought-leaders (KTLs), institutions, and organizations in their assigned geographical region. A RMAD focuses on medical & scientific engagement with identified healthcare and decision maker stakeholders by providing medical and scientific support via scientific exchange, addressing customers medical and scientific informational needs, and collaborating in mutually identified areas of medical, education, clinical research, and real-world experience/evidence. RMADs are recognized as an internal subject matter expert and provide appropriate medical and scientific support for internal teams as identified. Candidate to reside in: Houston, TX; San Antonio, TX; New Orleans, LA; or Jackson, MS Territory covers: TX, LA, MS Responsibilities Fostering mutually collaborative relationships with institutions, Centers of Excellence, thought leaders (TLs) and key decision makers across the healthcare ecosystem in the areas of medical, education, clinical research, and real world experience. Provide medical information through scientific exchange in a fair-balanced manner and clinical/scientific support as identified or requested in addressing the informational needs of the healthcare community, as well as responding to unsolicited requests for pipeline or off-label information. Delivering medical presentations to diverse healthcare professional (HCP) audiences including healthcare decision makers, professional medical societies, and identified advocacy groups. Providing scientific and liaison support related to Xeris clinical research activity, including thought leader and investigator engagement and follow-up, and facilitation of unsolicited requests for interactions related to Investigator Initiated Studies (IISs). Maintaining cross-functional collaboration with internal & external field teams to provide scientific expertise and medical support within Medical Affairs, Clinical Development, Commercial, and other internal stakeholders, etc. Obtaining, assimilating, organizing, and reporting appropriate competitive and scientific intelligence in a concise, clear manner, compliant with all applicable Xeris policies, procedures, and processes Attending & participating in medical/scientific meetings and conferences for the purpose of gaining scientific insights, collecting emerging scientific data, identifying healthcare trends, and supporting the scientific exchange and communication related to Xeris therapeutic areas of interest and research & development As identified, contribute to internal training for headquarter- and field-based teams and supporting speaker training initiatives. Assisting with the implementation and engagement of TL participation in advisory boards, consultant meetings and other scientific meetings consistent with all Xeris policies, procedures, and processes. Maintain clinical/scientific expertise and providing strategic insights into emerging scientific data and healthcare trends. Collaborating with TLs and Xeris Medical Communications to support the development of appropriate publications and related medical communications. Participate in assigned Medical Affairs projects, initiatives, and activities as identified and requested. Performing and completing administrative responsibilities, including reporting requirements in a timely fashion Qualifications Advanced degree (MD, PhD, PharmD, DNP) in a related discipline strongly preferred Less than 2 years of experience [Entry level as Associate Director]; 2+ years of experience [Entry Level as Director] of previous Field Medical or Medical Affairs pharmaceutical industry [post-doctoral pharmaceutical industry training via residency or fellowship also welcomed] Active clinical care, clinical research, or academia experience preferred Clear understanding of regional medical practice, clinical decision-making and healthcare systems affecting patient care. Demonstrated strong understanding of clinical research trial and/or related laboratory research design and execution Extensive knowledge of Endocrinology, including Cushing's Disease and field medical affairs is strongly preferred. Competencies: Customer Service focus, Teamwork & Collaboration, Written and Verbal Communication skills, Presentation skills, Time Management skills, Self-Starter. Working Conditions: Position may require periodic evening and weekend work, as necessary to fulfill obligations. Periodic overnight travel. Approximately 60% overnight travel The level of the position will be determined based on the selected candidate's qualifications and experience. #LI-REMOTE As an equal employment opportunity and affirmative action employer, Xeris Pharmaceuticals, Inc. does not discriminate on the basis of race, color, religion, sex, gender identity, sexual orientation, national origin, age, disability, veteran status, genetics or any other characteristic protected by law. It is our intention that all qualified applications are given equal opportunity and that selection decisions be based on job-related factors. The anticipated base salary range for this position is $170,000 to $225,000. Final determination of base salary offered will depend on several factors relevant to the position, including but not limited to candidate skills, experience, education, market location, and business need. This role will include eligibility for bonus and equity. The total compensation package will also include additional elements such as multiple paid time off benefits, various health insurance options, retirement benefits and more. Details about these and other offerings will be provided at the time a conditional offer of employment is made. Candidates are always welcome to inquire about our compensation and benefits package during the interview process. NOTE: This job description is not intended to be all-inclusive. Employee may perform other related duties as negotiated to meet the ongoing needs of the organization. Direct Employers Posting: Houston, TX; New Orleans, LA; Jackson, MS.

The Physical Health Medical Director plays a key role within the Physical Health Medical Management Team, providing clinical oversight, medical expertise, and operational support for physical health services. This position ensures high quality, evidence based medical review processes and supports organizational goals related to clinical quality, utilization management, and care coordination. This position will allow the successful candidate to work primarily remote. While there is no expectation to be in the office routinely, the selected candidate may be required to report on-site as needed. It's strongly preferred that the selected candidate reside in North Carolina or be willing to relocate. This position may be required to work weekends and holidays based on organizational and operational requirements. Responsibilities & Duties Clinical Oversight & Medical Review Provide expert guidance and oversight for physical health service requests, including authorization of services and determination of appropriate level of care Ensure the integrity and quality of utilization management activities, including initial reviews, concurrent reviews, appeals, and level of care determinations for inpatient and outpatient services Participate in internal reviews of inpatient and outpatient clinical case types to ensure compliance with regulatory, accreditation, and organizational standards Review Approval and Denial of Service and Level of Care Requests Apply medical necessity criteria utilizing review criteria hierarchy for level of care and services regarding type, amount, and duration of service. Complete expected case volume as expected by the department Process Adherence, Quality & Efficiency Follow department processes-as defined by approved Alliance policies, desk procedures, and workflows referenced on the Alliance Grid and in the Medical Director OneNote-to complete timely utilization reviews in Alliance's UM platform and perform tasks efficiently Apply established workflows and maintain quality case reviews to ensure consistent decision making, documentation accuracy, and adherence to regulatory compliance Operational & Committee Support Support the Clinical Operations Department through active participation in organizational committees, including but not limited to Clinical Quality Review, Transition of Care Rounds, Overturn Committee Provide clinical guidance and leadership to promote collaboration between medical, behavioral, and care management teams External Engagement Participate in mediation activities and Office of Administrative Hearing (OAH) processes as required, providing clinical expertise and documentation support Additional Responsibilities Maintain awareness of regulatory requirements, utilization management guidelines, and emerging trends affecting utilization management and physical health services Contribute to process improvement initiatives aimed at enhancing clinical quality, efficiency, and member outcomes Support cross functional teams with medical expertise, as needed Provide consultation, training, and education to staff and community partners on relevant topics as needed Train and mentor peers within the Medical Management team and assist with onboarding PH Medical Director new hires as needed Maintain a Positive Environment Work with Human Resources and Medical Team to attract, maintain, and retain a highly qualified and well-trained workforce Actively establish and promote a positive, diverse, and inclusive working environment that builds trust with teammates Ensure all staff are treated with respect and dignity Ensure standards are transparent and applied consistently, impartially, and ethically over time and across all staff members Minimum Requirements Education & Experience Graduation from an accredited Medical School. M.D./D.O. degree is required and board certification in a relevant field. At least four (4) years of postgraduate clinical experience and two (2) or more years of managed care and utilization management experience are required. Special Requirement Current, active, and unrestricted license to practice medicine in North Carolina or meets qualifications to obtain a North Carolina Medical License with Board certification for appropriate field of Medicine (American Board of Family Medicine or American Board of Internal Medicine). Knowledge, Skills, & Abilities Knowledge of the information and techniques needed for diagnosis and treatment of medical issues, including symptoms, treatment alternatives, drug properties and interactions, and preventive health-care measures Knowledge of Managed Care Principles Knowledge of recent developments in the field of medicine Microsoft Office Skills Ability to speak with colleagues about treatment concerns, complex case issues and best practice recommendations Utilization Management experience Salary Range $211,172 - $269,245/Annually Exact compensation will be determined based on the candidate's education, experience, external market data and consideration of internal equity An excellent fringe benefit package accompanies the salary, which includes: Medical, Dental, Vision, Life, Long Term Disability Generous retirement savings plan Flexible work schedules including hybrid/remote options Paid time off including vacation, sick leave, holiday, management leave Dress flexibility

If you are a current associate, you will need to apply through our internal career site. Please log into Workday and click on the Jobs Hub app or search for Browse Jobs. BluePearl is seeking an experienced, motivating, and driven clinical leader to join our team as a Group Medical Director - East Division. This is a remote position overseeing multiple hospital locations, with up to 60% overnight travel required. The Group Medical Director (GMD) has medical oversight of multiple markets within the organization with combined revenues of up to $150MM. The incumbent has the ultimate responsibility for translation of organizational objectives into market-specific objectives that instill a clinician-driven culture, promote clinician engagement and retention, and yield strong fiscal performance. A GMD frequently travels to hospitals to evaluate and mentor medical leaders and address concerns. The role partners with other members of the field leadership team to ensure a balanced representation of medical quality and financial considerations and the people & organization department to champion consistency in a high performance and engaged workforce united in being BluePearl. As a GMD, you will: Identify, oversee and develop medical leaders (Medical Directors and their ER Service Team Leads) to ensure optimal clinician productivity and engagement. Responsible for creating a clinician-driven culture in assigned markets. Serve as high-level representative and champion of BluePearl mission and vision in all interactions within the organization and external veterinary community. Partner with field leaders to effectively communicate and cascade key initiatives impacting medical staff. Foster a collaborative and trusting relationship between the support team and hospitals. Partner with field leaders to ensure appropriate productivity levels and growth plans for clinicians and hospitals, including maximizing technical teams. Monitor reports on operating costs within functional areas. Alerts hospital leaders of cost and labor over run. Partners with field leaders, finance and P&O to assess concerns and implement solutions. Own the success of on-site visit process for DVM candidates in assigned markets, ensures onboarding and mentoring of new BluePearl Clinicians through BluePearl Mentorship Program. Ensure standards for medical quality, patient safety reporting, equipment, and clinician productivity/performance are met. Partner with assigned Vet Relations team to collaborate on pDVM referral strategies that impact assigned markets. Oversee and encourage support of continuing education programs across assigned markets and ensures programs sufficiently develop and engage technicians and clinicians to deliver remarkable care to patients. Monitor reports on medical occurrences, patient safety and client experience and partners with stakeholders as needed to ensure swift resolution, improvements, and/or coaching as needed. Work collaboratively with the BluePearl Support Team to develop solutions for escalated concerns and influences medical leaders to shape adoption and ensure effectiveness of resolutions. Travel around 50% to ensure in-person leadership and mentoring in hospitals. EDUCATION/EXPERIENCE Bachelor's Degree and DVM (Doctor of Veterinary Medicine) required. Completion of 1-year rotating internship required. May be Emergency Clinician or board-certified Specialty Clinician. 7+ years of leadership experience required (previously overseeing multiple sites or revenues exceeding $25MM preferred.) Why BluePearl? Our passion is pets. We offer Trupanion pet insurance and discounts to our associates for pet treatments, procedures, and food. We encourage you to grow with us. Our technicians are leveled by their skillset and move up in level as they gain more skills and experience. We are focused on developing our associates into leaders through talent development programs and leadership workshops. As a member of Mars Veterinary Health, our associates have endless opportunities to advance in his/her career. In order to transform and lead the industry through innovative quality medicine and care, we understand the importance of continuous learning. We offer annual continuing education allowance, free continuing education sessions, our own BluePearl University for training, and our clinicians have access to over 2,000 medical journals. We value your health and well-being as an associate by providing you with the following: Health, dental, vision, and life insurance options. Annual company store allowance. Flexible work schedules. Time to reset, rewind, and reflect through our paid time off, paid parental leave, and floating holiday plans. A regional licensed social worker who can provide guidance, advice, and tips/tricks on how to maintain a healthy lifestyle while working in a fast-paced emergency and specialty care environment. We promote a family-like culture in our hospitals. We are all in this together. We believe in working together to lead the industry by enriching lives through remarkable care for pets BluePearl is committed to a diverse work environment in which all individuals are treated with respect and dignity. We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, creed, sex, age, disability, genetic information, marital status, citizenship status, sexual orientation or affectional preference, or gender identity or expression, protected veteran status, or any other characteristic protected by law. If you need assistance or an accommodation during the application process because of a disability, it is available upon request. The company is pleased to provide such assistance, and no applicant will be penalized as a result of such a request. We are an Equal Opportunity Employer and a Drug Free Workplace.

Do you want to be part of an inclusive team that works to develop innovative therapies for patients? Every day, we are driven to develop and deliver innovative and effective new medicines to patients and physicians. If you want to be part of this exciting work, you belong at Astellas! Astellas Pharma Inc. is a pharmaceutical company conducting business in more than 70 countries around the world. We are committed to turning innovative science into medical solutions that bring value and hope to patients and their families. Keeping our focus on addressing unmet medical needs and conducting our business with ethics and integrity enables us to improve the health of people throughout the world. For more information on Astellas, please visit our website at ***************** This position is based in Northbrook, Illinois. Remote work from certain states may be permitted in accordance with Astellas' Responsible Flexibility Guidelines. Candidates interested in remote work are encouraged to apply. Purpose and Scope: Responsible for overseeing the design and delivery of trials within a given late phase program or multiple early-phase programs in the Immuno-Oncology group. Reports to the Medical Lead/disease area strategy head for the given program(s) and is accountable for defining the strategy and execution of assigned trials. Clinical team leader with clear understanding of areas of responsibilities and accountabilities of the role. Team player who is comfortable in situations where the role serves as a consultant and support to other functions and particularly the asset area. Understands the criticality of information and knowledge management, partnership and collaboration required in drug development. Essential Job Responsibilities: Collaborates effectively with key internal and external stakeholders as a member of the asset team and leader of the clinical study team to advance one or more clinical trials. Serves as Medical Monitor w/ responsibility for safety monitoring. Ensures patient safety on clinical study is maintained. Generates safety related documents, such as medical monitoring reports and the safety database, to ensure that the reporting of SAEs is current and complete. Collaborates closely with safety officer in writing and/or reviewing Safety Narratives, Investigator Letters, and other safety documentation for site-reported safety events. Coordinates with Safety Officer on program for appropriate benefit-risk assessments, planning FIH study dose selection and escalation path for early-phase programs, safety management on trials, provides clinical input and review of clinical documents, statistical analysis plans, interim and final analyses on trials, publications, CSRs, DSURs and other critical documents. Able to assimilate Research, Clinical Pharmacology, Biomarker, medical safety, Toxicology (early phase programs) regulatory, biostatistics, medical affairs, Health Economics, commercial perspectives into clinical development strategies and trial designs. Responsible for managing the process of development of protocol and necessary regulatory documents. Accountable and responsible for development and implementation, and execution of clinical trials as part of a large complex late phase (post POC, established market) program or a group of earlier stage programs, in alignment with Asset and overall clinical strategy. In late phase program serves as the Lead for an indication specific clinical development team and is responsible and accountable for both strategy and execution of the clinical development plan for that indication or line of therapy. In earlier phases, serves as the clinical lead for the entire clinical development strategy and execution for a given program. Acquires public knowledge regarding therapeutic landscape, potential competitor products and serves as clinical voice regarding the potential for impact on planned clinical, medical affairs and commercial strategies. Creates and maintains scientific/clinical networks and seeks external opinion leader as appropriate. Serve as the clinical interface during clinical advisory boards, investigator meetings, and interactions with opinion leaders. Serves as the clinical interface in regulatory authority interactions. Accountable for clinical development milestones for their given trials. Supports Medical lead and Asset team at governance meetings and can present the clinical development plan in a succinct and clear manner at such meetings. Works with Development Scientists and Clinical Operation Leads to ensure efficient and streamlined execution of clinical trials and acquisition and interpretation of high-quality clinical data to inform program-level decision making and overall development strategies. Designs scientifically rigorous, cost-effective, and patient-centric clinical trials in accordance with the Clinical development Plan. Accountable for Clinical trial scope development and authoring of the protocol, IB, ICF as appropriate, in coordination with development scientists, clinical operations, medical writing and regulatory. Responsible for keeping medical lead, asset lead and Development Head informed on progress of trials, risks, planned/required mitigations, and changes to timelines and budgets. Supports clinical development related initiatives as needed. Leads and/or participates in scientific and medical training to other team members and external clients, investigators, and other site staff as it pertains to assigned studies.

Required licensure: TX, KY, FL, WA licenses are preferred The Behavioral Health Physician will serve as an independent contractor providing physician-level utilization management (UM) services for behavioral health services. This role is non-clinical and limited exclusively to medical necessity determinations, peer-to-peer reviews, and appeals in accordance with applicable regulations, accreditation standards, and plan policies. Scope of Services The Contractor will perform UM activities including, but not limited to: Initial Medical Necessity Reviews for behavioral health services requiring physician-level determination Concurrent Reviews for continued authorization of services Peer-to-Peer (P2P) Reviews with treating providers Appeals Reviews, including first- and second-level determinations, as applicable Issuance of adverse determinations when clinically indicated, ensuring compliance with federal and state regulations, parity requirements, and plan policies Documentation of determinations in UM systems with clear clinical rationale and supporting criteria Participation in quality improvement processes related to UM decisions, as requested Exclusions / Non-Scope This role does not include: Direct patient care or treatment Prescribing services Care coordination or case management Administrative leadership or supervisory responsibilities Clinical Expertise & Requirements MD or DO with board certification in Psychiatry (required) Active, unrestricted medical license in applicable state(s) of review Experience in behavioral health utilization management, preferably in managed care or health plan settings Demonstrated knowledge of: Medical necessity criteria (e.G., MCG, InterQual, or equivalent) Federal and state behavioral health regulations MHPAEA requirements NCQA and CMS standards Strong peer-to-peer communication skills Work Expectations Remote work environment Flexible scheduling based on case volume and turnaround time requirements Ability to meet required regulatory and contractual decision timelines Maintain confidentiality and comply with HIPAA and data security standards Reporting & Oversight Operates independently while adhering to health plan UM policies, delegated authority parameters, and medical policy Subject to audit, quality oversight, and performance monitoring consistent with UM regulatory requirements

Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to transform our health care system while creating a healthier community. Martin's Point employees enjoy an organizational culture of trust and respect, where our values - taking care of ourselves and others, continuous learning, helping each other, and having fun - are brought to life every day. Join us and find out for yourself why Martin's Point has been certified as a "Great Place to Work" since 2015. Position Summary The Medical Director (MD) provides clinical leadership and direction to the utilization & care management functions of Martin's Point's Health Plans. The MD works collaboratively with other plan functions that interface with Medical Management such as Health Management, Compliance and Appeals, , Network Management, Member Services, benefits & claims management, and Compliance. In this role, there is the opportunity to assist in or drive short and long-range clinical programming, quality management, and external relationships. The Medical Director reports to the Vice President Health Plan Medical Director and works closely with the other Health Plan leaders. Job Description Key Outcomes: * Responsible and accountable to the Health Plan Medical Director for helping to manage health plan medical costs by assuring clinically appropriate health care delivery for health plan products and services utilizing Evidence-Based Guidelines to ensure the right service at the right time and place for each member * Performs medical necessity reviews of requests for health plan-covered services (benefits). Reviews disputes and appeals of said services for clinical appropriateness and in compliance with government program rules * Contributes to case reviews to ensure the quality and safety of care and services delivered to Martin's Point Health Plan members. * Assists in the construction of the annual Utilization Management, Care Management, and Disease Management Program Descriptions and works to ensure the programs meet accreditation and regulatory standards (e.g. NCQA, CMS, TRICARE) * Participates in medical policy review and policy development. * Works with Informatics, Network Management, and Medical Economics to create and maintain a system where Network providers are properly assessed in regard to cost management and develops a plan and schedule for communication and solutioning with outliers. * Develops an in-depth understanding of ACOs and contributes to their management and strategic deployment. * Provides support to Health Plan risk adjustment activities as needed. * Is conversant with Health Plan key performance metrics, in particular utilization and cost management goals, MLR , inpatient days/1000, SNF days/1000, and clinical quality improvement (QI) objectives, including HEDIS and how to drive improvement in these areas Education/Experience: * Board certified physician with post-graduate experience in direct patient care required * Medical leadership in, or focused activity of, a Health Plan (preferred) * Knowledge of process improvement tools * Experience in Health Plan utilization management * Experience in Medicare Advantage and/or TriCare preferred Required License(s) and/or Certification(s): * Active and unrestricted license to practice medicine in Maine or New Hampshire; or another U.S. state with eligibility to apply for and obtain additional state licensure. * Current, or ability to have some, active clinical work with patients Skills/Knowledge/Competencies (Behaviors): * Deep knowledge and practical understanding of Health Care systems and Managed Care concepts * Knowledge and deep commitment to performance-based Health Plan systems * Good analytic skills with the ability to identify meaningful trends and targets for improvement * Excellent interpersonal skills and demonstrated ability to establish rapport and working relationships with providers, service vendors and internal staff * Willingness to explore innovative methods of providing medical management * Supports the culture and models the MPHC values This position is not eligible for immigration sponsorship. We are an equal opportunity/affirmative action employer. Martin's Point complies with federal and state disability laws and makes reasonable accommodations for applicants and employees with disabilities. If a reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact ***************************** Do you have a question about careers at Martin's Point Health Care? Contact us at: *****************************

HJ Staffing is urgently seeking a Medical Director of Utilization Management to join a leading Medicare Advantage Health Plan. This physician leader will play a critical role in ensuring the clinical integrity of inpatient and post-acute care reviews, evaluating medical necessity to support optimal outcomes and regulatory compliance. Location: 100% Remote Schedule: Full-Time, Monday - Friday (Must work PST hours) Job Description Reporting to the Chief Medical Officer, the Medical Director focuses on Evaluating hospital admissions, continued stays, and post-acute services for Medicare Advantage members. You will guide timely care determinations using CMS regulations and evidence-based practices (MCG/InterQual) while collaborating with care management teams and external providers. What You Will Do Clinical Review: Conduct timely medical necessity determinations for inpatient admissions and post-acute settings (SNF, IRF, LTACH, and Home Health). Criteria Application: Use evidence-based guidelines (MCG/InterQual) and CMS criteria to assess the appropriateness of acute care services. Peer-to-Peer: Lead discussions with attending physicians to clarify clinical documentation and support appropriate levels of care. Complex Case Management: Serve as the primary physician reviewer for escalated or complex UM cases requiring expert medical judgment. Collaboration: Partner with utilization and care management teams to ensure consistent, cost-effective care and participate in UM committee meetings. Compliance & Documentation: Ensure all decisions are documented according to NCQA and CMS requirements; support audit preparedness and delegated oversight. Utilization Trends: Identify patterns in care and support interventions to reduce unnecessary admissions or extended stays. What You Will Bring Credentials: Licensed M.D. or D.O. in good standing in your state of residence. Clinical Experience: Minimum of 5 years of clinical experience. Managed Care Expertise: At least 3 years in a utilization management or medical leadership role within a managed care or health plan setting. Specialized Knowledge: Strong experience in inpatient/post-acute case review and deep knowledge of Medicare Advantage regulations and CMS coverage criteria. Technical Skills: Extensive experience with MCG guidelines and advanced proficiency in MS Office and medical management software. Education (Preferred): MPH, MBA, or MHA; Certification by the American Board of Quality Assurance and Utilization Review Physicians (ABQAURP). You Will Be Successful If: You are an expert in using data to design and implement clinical programs and population health management. You possess strong negotiation skills, particularly in physician-to-physician interactions. You thrive in a matrix organization and can mentor staff while making independent, high-stakes decisions. You have a meticulous eye for detail and can maintain a reasonable rate of speed in a fast-paced, high-volume environment. You are committed to the highest standards of confidentiality and clinical documentation.

Job DescriptionMEDICAL DIRECTOR - REMOTE ARC Group has an immediate opportunity for a Medical Director! This position is 100% remote working eastern time zone business hours. This is a direct hire FTE position and a fantastic opportunity to join a well-respected organization and have a positive impact on the lives of millions of people. At ARC Group, we are committed to fostering a diverse and inclusive workplace where everyone feels valued and respected. We believe that diverse perspectives lead to better innovation and problem-solving. As an organization, we embrace diversity in all its forms and encourage individuals from underrepresented groups to apply. 100% REMOTE! Candidates must currently have PERMANENT US work authorization. Sorry, but we are not considering any candidates from outside companies for this position (no C2C, 3rd party / brokering). SUMMARY STATEMENT The Medicare Contractor Medical Director (CMD) provides medical leadership and decision making for an organization that serves as a Medicare Administrative Contractor (MAC). This role serves as a liaison between the Centers for Medicare and Medicaid Services (CMS) and stakeholders. CMDs play a vital role in developing Local Coverage Determinations (LCDs) and ensuring compliance with Medicare policies, reviewing medical claims, and promoting evidence-based healthcare. ESSENTIAL DUTIES & RESPONSIBILITIES Clinical Expertise and Consultation 30% Provide leadership in clinical program outreach to the practitioner/provider/supplier/beneficiary community. Provide direction and assistance to clinical staff in conducting provider education, as well as assist in the development of clinical guidelines as needed. Keep clinical knowledge up to date and abreast of medical practice and technology changes. Serve as a subject matter expert in medical and clinical areas relevant to the Medicare program. Provide clinical consultation to internal teams (e.g., medical review staff, appeals teams) and external stakeholders. Provide the clinical expertise, scientific literature analysis, claims data analytics to effectively focus medical polical policy and reviews on identified problem areas. Collaboration and Leadership 30% Collaborate with CMS and other Medicare Contractors (e.g., A/B or DME MACs and others) to develop and update medical policies and articles based on clinical evidence and regulatory requirements. Work with multidisciplinary teams within the MAC to improve processes and ensure compliance with CMS directives. Liaise with CMS staff, medical societies, and other stakeholders to align goals and address emerging issues. Represent the MAC at CMS meetings and industry conferences. Strengthen the quality improvement procedures with emphasis on decision consistency and clinical education of clinical staff through various mechanisms including but not limited to overseeing Inter-Reviewer Reliability (IRR) reviews. Program Integrity 20% Support program integrity initiatives, including identifying trends in inappropriate billing practices or noncompliance. Ensure the proper application of Medicare regulations, national and local coverage determinations (NCDs and LCDs), and clinical guidelines. Participate in all phases of LCD development by leading the Local Coverage Determination (LCD) process to include development, revision, retirement, education, and decision making. Collaborate with investigative teams and law enforcement when required. Medical Review (MR) and Appeals 10% Oversee medical review activities to ensure appropriate and consistent decisions on claim determinations including pre- and post-payment determinations. Provide leadership in developing and implementing MR Quality Assurance Programs. Provide leadership in effectively focusing MR and developing internal MR guidelines. Review complex or high-level appeals and provide guidance on the application of Medicare policies. Provide support to the claim appeal process including assistance in the development of position papers and participation in the administrative process when needed such as Administrative Law Judge (ALJ) hearings. Provider Education and Communication 10% Provide leadership in the provider community (including interacting with hospital/specialty associations). Educate providers, individually or as a group, regarding identified problems or medical policy. Maintain Professional and Organization Relationships Performs other duties as the supervisor may, from time to time, deem necessary. Travel within and outside the assignedjurisdictions, as needed. Expected to be no more than 3-4 weeks/year but could vary based on business needs. REQUIRED QUALIFICATIONS MD or DO degree from accredited Medical School Minimum of three years clinical practice experience as an attending physician Extensive knowledge of the Medicare program, particularly the coverage and payment rules Work experience in the health insurance industry, a utilization review firm, or another health care claims processing organization in a role that involved developing coverage or medical necessity policies and guidelines. Knowledge, skill, and experience to evaluate clinical evidence, and to develop evidence-based medical necessity standards within the Medicare fee-for-service benefit structure Ability to develop strategies and processes to ensure evidence-based decision-making for policy in the Medicare population Basic understanding of medical coding conventions Ability to effectively communicate, collaborate with, and provide education on health care policy issues to both internal team members and external entities Ability to work collaboratively with internal staff to evaluate aberrancies, determine appropriate billing, coding, pricing, and utilization of services Proficiency with effective public speaking and ability educate providers Ability to work collaboratively with clinical and non-clinical team members Ability and desire to educate team members and external entities (i.e., CMS, providers, other federal agencies, law enforcement, etc.) Computer literacy, including proficiency using word processing, spreadsheets, presentation, and virtual meeting applications Ability to complete independent or computer-based training and education Certifications, Licenses, Registration: Current, active, valid, unrestricted license to practice medicine in at least one state or territory within the United States, never suspended or revoked in any state or territory of the United States Eligible for licensure within jurisdiction of enterpriseoperations Board Certified Doctor of Medicine or a Doctor of Osteopathy in a specialty recognized by the American Board of Medical Specialties for at least three years PREFERRED QUALIFICATIONS Experienced Physical Medicine and Rehabilitation (PM&R), Oncology, Radiology, Ophthalmology or Infectious Diseases professionals with five years of clinical practice MBA, MHA, MS in Management, or formal accredited coursework in medical systems management Demonstrated successful working experience in organized medicine group(s) (e.g., AMA, specialty society, state health department) as a committee chairperson or other leadership Medical Director experience in Medicare-related or commercial healthcare organization Coding and billing experience utilizing HCPCs, CPT, and ICD-10 codes Experience using GRADE methodology for literature analysis and performing systematic reviews Experience working with physician groups, beneficiary organizations, and/or congressional offices Would you like to know more about our new opportunity? For immediate consideration, please send your resume directly to John Burke at ******************** or apply online while viewing all of our open positions at ******************* ARC Group is a Forbes-ranked a top 20 recruiting and executive search firm working with clients nationwide to recruit the highest quality technical resources. We have achieved this by understanding both our candidate's and client's needs and goals and serving both with integrity and a shared desire to succeed. At ARC Group, we are committed to providing equal employment opportunities and fostering an inclusive work environment. We encourage applications from all qualified individuals regardless of race, ethnicity, religion, gender identity, sexual orientation, age, disability, or any other protected status. If you require accommodations during the recruitment process, please let us know. Position is offered with no fee to candidate.

The Medical Director, Rheumatology and/or Dermatology Medical Strategy is a critical role responsible for shaping the strategic processes and planning for assets in early development (e.g., pre-Phase 3) within the Nephrology and Immunology portfolio. This position manages the unique challenge of establishing an emerging portfolio, incorporating newly acquired assets, which requires significant scientific and strategic agility and a strong ability to balance competing priorities. This position reports directly to the Senior Director, Immunology Lead, who in turn reports to the Executive Director, Nephrology & Immunology Lead. **** **Key Responsibilities Include:** **Medical Strategy & Narrative** + Provide key medical input into the initial development of the Target Reimbursable Product Profile as well as early development plans ensuring scientific consistency and alignment across R&D, Clinical, Global Medical Affairs, and Early Commercialization functions + Provide high-quality scientific/clinical input and review of early asset plans, ensuring content aligns with the overarching Medical Narrative + Serve as a primary scientific resource, providing guidance on the disease state and mechanism of action for the early Nephrology and Immunology portfolio helping to translate science into value for patients and stakeholders + Lead the Strategy and Tactical Planning Process, identifying critical data needs for the emerging portfolio **Evidence Generation Process** + Oversee the Medical Evidence Generation Process, translating strategic data gaps into clear research priorities and providing expert input into the design and feasibility of clinical trials and data generation initiatives + Support the planning and execution of Medical Affairs evidence generation activities relevant to early assets **External Stakeholder Engagement** + Identify and engage Medical experts to support collection, curation and communication of clinical Medical and methodological insights to inform understanding of unmet medical needs, emerging standard of care and development opportunities + Develop Key Intelligence Topics & Questions (KITs/KIQs) for relevant assets, serving as the blueprint for insight collection from Medical Experts + Lead the strategic planning, content development, and successful facilitation of consulting activities including Advisory Boards, ensuring objectives align with data gap analyses and asset/portfolio strategy + Lead scientific exchange with Medical Experts to gather insights and validate development hypotheses + Support the development of scientific publications, abstracts, and presentations related to early assets **Cross-functional Integration & Planning** + Collaborate within the Nephrology & Immunology Medical Business Unit with the Nephrology & Immunology Medical Communications and Field Medical Affairs sub-teams + Partner with and serve as a scientific and clinical resource for cross-functional colleagues including Clinical Development, Global Integrated Evidence & Innovation, Regulatory and Global Marketing and Market Access + Support indication prioritization and portfolio planning for early assets + Consider technology and AI to support workflow improvement **Qualifications** **Education and Experience:** + Advanced scientific degree is required (PharmD, MD, PhD, or equivalent) with expertise in **Rheumatology and/or Dermatology** + Preference for previous experience in Clinical Development, Research, or early-stage Medical Affairs + Expertise in Rheumatology or Dermatology is strongly preferred + Experience supporting BD evaluations for potential acquisitions + Experience contributing to the integration and strategic planning for newly acquired or in-licensed assets + Proven experience managing Evidence Generation processes and executing scientific Advisory Boards **Skills and Competencies:** + Motivated and solution-oriented with the ability to work collaboratively across the organization, particularly with R&D and Clinical teams + Strategic agility required to build and adapt scientific strategy for an emerging portfolio + Excellent communication and interpersonal skills, including experience presenting complex development strategies to large internal groups and engaging a limited number of highly specialized external experts + Full understanding of rules and regulations in pharma, with the ability to apply knowledge of guidelines and regulations to early-stage Medical Affairs activities + Ability to work in a fast-paced, dynamic environment, with a proactive and problem-solving mindset + Strong understanding of drug development processes, especially early-stage development + \#LI-PG1 **Competencies** **Accountability for Results -** Stay focused on key strategic objectives, be accountable for high standards of performance, and take an active role in leading change. **Strategic Thinking & Problem Solving -** Make decisions considering the long-term impact to customers, patients, employees, and the business. **Patient & Customer Centricity -** Maintain an ongoing focus on the needs of our customers and/or key stakeholders. **Impactful Communication -** Communicate with logic, clarity, and respect. Influence at all levels to achieve the best results for Otsuka. **Respectful Collaboration -** Seek and value others' perspectives and strive for diverse partnerships to enhance work toward common goals. **Empowered Development -** Play an active role in professional development as a business imperative. Minimum $209,599.00 - Maximum $313,375.00, plus incentive opportunity: The range shown represents a typical pay range or starting pay for individuals who are hired in the role to perform in the United States. Other elements may be used to determine actual pay such as the candidate's job experience, specific skills, and comparison to internal incumbents currently in role. Typically, actual pay will be positioned within the established range, rather than at its minimum or maximum. This information is provided to applicants in accordance with states and local laws. **Application Deadline** : This will be posted for a minimum of 5 business days. **Company benefits:** Comprehensive medical, dental, vision, prescription drug coverage, company provided basic life, accidental death & dismemberment, short-term and long-term disability insurance, tuition reimbursement, student loan assistance, a generous 401(k) match, flexible time off, paid holidays, and paid leave programs as well as other company provided benefits. Come discover more about Otsuka and our benefit offerings; ********************************************* . **Disclaimer:** This job description is intended to describe the general nature and level of the work being performed by the people assigned to this position. It is not intended to include every job duty and responsibility specific to the position. Otsuka reserves the right to amend and change responsibilities to meet business and organizational needs as necessary. Otsuka is an equal opportunity employer. All qualified applicants are encouraged to apply and will be given consideration for employment without regard to race, color, sex, gender identity or gender expression, sexual orientation, age, disability, religion, national origin, veteran status, marital status, or any other legally protected characteristic. If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation, if you are unable or limited in your ability to apply to this job opening as a result of your disability. You can request reasonable accommodations by contacting Accommodation Request (EEAccommodations@otsuka-us.com) . **Statement Regarding Job Recruiting Fraud Scams** At Otsuka we take security and protection of your personal information very seriously. Please be aware individuals may approach you and falsely present themselves as our employees or representatives. They may use this false pretense to try to gain access to your personal information or acquire money from you by offering fictitious employment opportunities purportedly on our behalf. Please understand, Otsuka will **never** ask for financial information of any kind or for payment of money during the job application process. We do not require any financial, credit card or bank account information and/or any payment of any kind to be considered for employment. We will also not offer you money to buy equipment, software, or for any other purpose during the job application process. If you are being asked to pay or offered money for equipment fees or some other application processing fee, even if claimed you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to exercise caution when you receive such an offer of employment. Otsuka will also never ask you to download a third-party application in order to communicate about a legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo, Gmail, Hotmail, etc, and not from an official Otsuka email address. Please take extra caution while examining such an email address, as the scammers may misspell an official Otsuka email address and use a slightly modified version duplicating letters. To ensure that you are communicating about a legitimate job opportunity at Otsuka, please only deal directly with Otsuka through its official Otsuka Career website ******************************************************* . Otsuka will not be held liable or responsible for any claims, losses, damages or expenses resulting from job recruiting scams. If you suspect a position is fraudulent, please contact Otsuka's call center at: ************. If you believe you are the victim of fraud resulting from a job recruiting scam, please contact the FBI through the Internet Crime Complaint Center at: ******************* , or your local authorities. Otsuka America Pharmaceutical Inc., Otsuka Pharmaceutical Development & Commercialization, Inc., and Otsuka Precision Health, Inc. ("Otsuka") does not accept unsolicited assistance from search firms for employment opportunities. All CVs/resumes submitted by search firms to any Otsuka employee directly or through Otsuka's application portal without a valid written search agreement in place for the position will be considered Otsuka's sole property. No fee will be paid if a candidate is hired by Otsuka as a result of an agency referral where no pre-existing agreement is in place. Where agency agreements are in place, introductions are position specific. Please, no phone calls or emails.

Site: Mass General Brigham Health Plan Holding Company, Inc. Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. Job Summary Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are on the forefront of transformation with one of the world's leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage. Our work centers on creating an exceptional member experience - a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a consciously inclusive environment where diversity is celebrated. We are pleased to offer competitive salaries, and a benefits package with flexible work options, career growth opportunities, and much more. Under the direction of the Senior Medical Director, the Medical Director leads as a senior physician at the health plan. This position works closely with the Senior Medical Director in providing medical management leadership for clinical services operations and programs. This role focuses on and has expertise in utilization management, health plan quality and accreditation, care management, and other health plan functions. Qualifications Licensure and Credentials: Must maintain an active full physician license in Massachusetts Experience: * 3-5 years of Health Plan experience * at least 5 years of clinical practice experience Job Duties: Handles utilization management initial determinations, appeals and grievances within the scope of their expertise as defined by Medicare, MassHealth, NCQA and the Division of Insurance and within the compliance requirements of key regulatory and accreditation entities * Reviews clinical services and quality incidents when sufficiently serious to merit physician involvement * Coverage of medical necessity determinations to support special investigations/fraud waste and abuse cases * Collaborates on health plan medical policy development * Assesses new, emerging, and existing technologies to determine appropriateness of health plan coverage * Partners with clinical leaders to ensure medical service expenditures remain within budget * Collaborates with business development, quality, finance and medical management teams to promote improvements in the quality and cost efficiency of care throughout the MGB Health Plan provider network * Delivers consultation to network management staff and deployment of education programs for network clinicians * Develops and delivers presentations for clinical staff on current topics relevant to MGB Health Plan members and network * May represent MGB Health Plan at a variety of external forums and committees * Interact, communicate and collaborate with network and community physicians, hospital leaders and other vendors regarding care and services for enrollees * Monitors performance metrics and audits to identify areas for continuous improvement and ensure compliance * Anticipates and meets or exceeds internal and/or external customer expectations and requirements; establishes and maintains positive relationships with customers and gains their trust and respect * Build strong relationships and infrastructure that designate MGB Health Plan as a people-first organization * Ensure diversity, equity and inclusion are integrated as a guiding principle * Other duties as assigned with or without accommodation Additional Job Details (if applicable) Primarily remote position, exempt * In person meetings as requested for business needs * Participates in after hours and weekend call rotation as assigned Remote Type Remote Work Location 399 Revolution Drive Scheduled Weekly Hours 40 Employee Type Regular Work Shift Day (United States of America) EEO Statement: Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at **************. Mass General Brigham Competency Framework At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.

The Medical Director, Radiation Oncologist is a key clinical leader responsible for managing and further developing the NantHealth, Inc. Eviti Solution, including oversight of the Medical Office professional staff of oncology nurse practitioners and radiation oncologists who conduct medical record and treatment plan review, systems input, and reporting to payer clients through the eviti | Connect platform. The Eviti Solution Medical Office functions to ensure that radiation oncology treatments comply with evidence-based medicine, nationally recognized best practices, and payer-defined standards of medical necessity, with the goal of supporting delivery of the highest-quality, most appropriate care to patients. This is a pivotal, national-impact role, with the Medical Director, Radiation Oncology serving as a key clinical interface between payer clients, treating physicians, and NantHealth clinical staff, while supporting day-to-day treatment plan review operations. The Medical Director, Radiation Oncology will serve as the primary clinical consultant for the eviti | Connect product, conducting peer-to-peer discussions with radiation oncology providers regarding patient treatment plans. The Director will be located within the continental United States or its territories when conducting peer-to-peer consultations. In addition to radiation oncology oversight, this role will play a key leadership role in oncology imaging utilization management. Responsibilities include the development, refinement, and ongoing maintenance of oncology imaging guidelines, as well as the creation of new tumor-specific and scenario-based imaging criteria. The Director will lead and participate in multidisciplinary oncology and imaging committees, ensure timely updates to imaging guidance as standards of care evolve, and integrate imaging decision-making with radiation treatment planning, disease stage, treatment intent, and line of therapy. This work is central to ensuring that oncology imaging guidance remains clinically nuanced, evidence-based, and aligned with modern oncology practice rather than siloed or purely radiology-driven. This is a full time, remote position, requiring availability to regularly work 40 hours per week, including holidays and weekends as necessary. Responsibilities include, but are not limited to: Oversee all aspects of radiation oncology treatment plan reviews performed by NantHealth Eviti radiation oncology consultants, oncology-certified nurses, and nurse practitioners, including integration of imaging considerations into treatment decision-making. Provide assurance to payer clients that radiation oncology and oncology imaging treatment plans are consistent with evidence-based care or represent medically justified deviations supported by clinical documentation. Further develop internal processes, workflows, and performance metrics to support a high-performing, disciplined approach to client service delivery, including consistent and timely reporting within established turnaround times. Ensure that radiation oncology and oncology imaging content within the Eviti regimen and guideline libraries is current, comprehensive, accurate, and reflective of evolving standards of care. Ensure that all clinical and utilization reporting is timely, accurate, and consistent with NantHealth Eviti-approved processes and quality standards. Lead peer-to-peer discussions with treating physicians in a highly professional, collaborative, and clinically credible manner, addressing both radiation treatment plans and associated oncology imaging decisions as appropriate. Collaborate with the NantHealth client management team and the Eviti Director of Clinical Operations to support and manage strategic relationships with client medical officers and senior clinical leadership. Execute programs, standards, and operational improvements that continue to enhance the capability, capacity, quality, and productivity of the NantHealth Eviti Medical Office and clinical staff. Provide ongoing education to NantHealth Eviti clinical staff on advances in radiation oncology and oncology imaging, including emerging technologies, evolving clinical indications, and guideline updates. Provide guidance and updates to NantHealth Eviti clinical staff and Development teams regarding billing, coding, and reimbursement considerations for radiation oncology and oncology imaging services. Participate in quality assurance, performance improvement, and internal educational initiatives, including review of clinical outcomes, guideline adherence, and peer review activities. Maintain continuous self-education and expand expertise in high-quality, cost-effective radiation oncology and oncology imaging practices. Serve as a thought leader in evidence-based radiation oncology and oncology imaging, proactively contributing to clinical leadership, guideline development, and professional discourse within the oncology community. Education & Experience Requirements: Possess a Current Active Unrestricted Physician License in the United States or its territories Board Certification in Radiation Oncology A minimum of 5 years of oncology practice experience in a community or academic setting with an acute understanding of day-to-day cancer care Proven clinical leadership experience, with a record of scholarly activity, publications, or involvement in guideline development preferred. Strong understanding of radiation oncology practice and the healthcare insurance landscape, including medical necessity, utilization management, and payer policy considerations for related conditions. Excellent organizational skills with strong attention to detail and the ability to manage multiple priorities effectively. Required Knowledge, Skills, and Abilities: Outstanding interpersonal and collaborative skills, with the ability to engage effectively with physicians, clinical staff, medical management, and cross-functional teams. High level of computer proficiency, including Microsoft Word, Excel (data creation and analysis), and PowerPoint; comfort working within clinical decision-support platforms. Familiarity with relational database concepts and clinical data systems preferred but not required. Strong numerical aptitude and understanding of basic statistical concepts, with the ability to interpret and apply data to clinical decision-making. Excellent oral and written communication skills, with well-developed analytical and problem-solving abilities. Decisive, proactive, and adaptable, with a hands-on mindset and a willingness to engage directly in problem resolution. Ability to thrive in a fast-paced, rapidly evolving environment, balancing strategic thinking with practical execution. Demonstrated ability to build and maintain professional relationships across industry, physician networks, academia, and governmental or regulatory entities. Highly motivated, energetic, and passionate about improving the quality, value, and integrity of autoimmune care. Unwavering commitment to ethical conduct, scientific rigor, and professional integrity. Possess a strategic mindset while also demonstrating the ability to manage the operational and tactical aspects of the role Demonstrate superior written and verbal communication and presentation skills Demonstrate the ability to apply sound clinical judgment in complex or ambiguous cases where evidence, guidelines, and payer policy may not fully align Exhibit natural gravitas, credibility, and the ability to influence clinical and non-clinical stakeholders Be approachable, collegial, easy to engage, and demonstrate intellectual curiosity Have the ability to lead and manage staff in remote and distributed environments Be technologically adept, comfortable working with software platforms and clinical decision-support tools Be a strong problem solver, able to quickly identify issues, consider multiple perspectives, and navigate complex or difficult situations diplomatically Be proactive, well organized, and highly reliable in managing responsibilities Understand the intersection of clinical care, payer policy, medical necessity, and regulatory requirements, and communicate effectively across those domains The salary for applicable US-based applicants to this position is below. The specific rate will depend on the successful candidate's qualifications, prior experience as well as geographic location. $340,000 base salary plus bonus potential.