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Medical Director - Medicare Case Management

Remote, USA Full-time Posted 2025-11-03
Description: • Provides clinical oversight of case management teams. • Participates in the development of Individual Care Plans (ICP). • Collaborates with leadership to ensure objectives are met. • Consults with plan medical staff on adverse determinations. • Delivers highest quality care in an effective manner. • Contributes to strategies and programs for community engagement. • Develops clinical training for case management staff. • Ensures timely execution of all deliverables. • Interprets utilization data and proposes clinical improvements. • Participates in UM activities and on-call schedule as needed. Requirements: • Active and current medical license in Florida (MD or DO). • Board Certification in Family Practice, Internal Medicine, or Geriatrics. • Post-graduate direct patient care experience. • 3-5 years of Managed Care experience; Medicare highly preferred. • 3-5 years of Case Management experience. • Ability to work effectively in a highly matrixed organization. • Ability to engage with all levels including clinical leaders and staff. • Flexibility with work schedule to meet business needs. • Ability to be agile and manage multiple priorities. Benefits: • Full range of medical, dental, and vision benefits. • 401(k) retirement savings plan. • Employee Stock Purchase Plan available. • Fully-paid term life insurance plan. • Short-term and long-term disability benefits. • Numerous well-being programs. • Education assistance and free development courses. • CVS store discount and discount programs with partners. • Paid Time Off (PTO) and paid holidays. Apply Job!  

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