Medical Director, Clinical Specialty in United States at Jobgether
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Job Description
This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Medical Director, Clinical Specialty in the United States.
This clinical leadership role is focused on advancing evidence-based care management and improving outcomes across complex patient populations. You will serve as a key medical expert, guiding clinical decision-making, utilization management strategies, and quality improvement initiatives within a high-performing healthcare environment. The role requires close collaboration with care teams, operational leaders, and external stakeholders to ensure medically appropriate, cost-effective, and patient-centered care. You will provide clinical oversight, contribute to policy development, and support escalated case reviews requiring physician-level expertise. This position also plays an important role in shaping clinical guidelines and ensuring alignment with regulatory and quality standards. It is a highly impactful role combining clinical practice knowledge with strategic healthcare leadership.
- Provide clinical leadership and medical expertise to support utilization management, care coordination, and complex case review decisions.
- Evaluate medical necessity and appropriateness of services while ensuring alignment with evidence-based guidelines and regulatory requirements.
- Collaborate with interdisciplinary care teams and operational leaders to improve clinical outcomes and patient experience.
- Support development and refinement of clinical policies, protocols, and care management strategies.
- Participate in escalated case reviews, peer discussions, and medical determinations requiring physician-level judgment.
- Contribute to quality improvement initiatives aimed at enhancing efficiency, safety, and care effectiveness.
- Engage with internal stakeholders to support training, education, and clinical alignment across teams.
- Medical degree (MD or DO) with active and unrestricted U.S. medical license.
- Board certification in a relevant clinical specialty required.
- 5+ years of clinical practice experience, with exposure to utilization management, care management, or payer/health plan environments preferred.
- Strong understanding of evidence-based medicine, clinical guidelines, and healthcare quality standards.
- Excellent communication skills with the ability to explain complex clinical decisions clearly to non-clinical stakeholders.
- Experience working collaboratively in multidisciplinary teams and healthcare operations environments.
- Strong analytical thinking, clinical judgment, and decision-making abilities.
- Prior experience in managed care, insurance, or healthcare technology settings is a plus.
- Competitive compensation aligned with clinical leadership roles
- Comprehensive medical, dental, and vision insurance coverage
- Flexible work arrangements, including remote or hybrid options depending on role requirements
- Paid time off and company holidays
- Opportunities for professional development and continuing medical education support
- Retirement savings plan options (e.g., 401(k) where applicable)
- Mission-driven environment focused on improving patient outcomes and healthcare quality
- Inclusive and collaborative workplace culture.