Medical Director for Health Plan (Full-time or Part-time)

TL;DR

Medical Director for Health Plan: Lead medical policy and utilization management for a technology-enabled health plan with an accent on regulatory updates, care guidelines, and quality healthcare delivery. Focus on developing strategies, overseeing review processes, and integrating clinical best practices into program development.

Location: Remote (must reside in the United States and in the Eastern or Central time zone). Company business hours 9-5 CST.

Company

Technology-enabled health plans division of Globe Life (NYSE:GL) with a mission to expand benefits, increase access, and provide personalized care.

What you will do

• Lead utilization management strategy and oversight of medical necessity determinations.
• Own medical policy development incorporating regulatory and guideline changes.
• Partner with the Utilization Management Review Committee and provide medical oversight for cost-effective care.
• Review case management data to identify trends and recommend actions.
• Direct staff training, integrate clinical quality practices, and evaluate new programs.
• Investigate care management technologies for impact on providers and patients.

Requirements

• Active, unrestricted Texas (TX) medical license without limitations or sanctions.
• Doctor of Medicine (MD) with 8+ years of clinical experience; management experience preferred.
• Board certification in a specialty recognized by the American Board of Medical Specialties.
• Experience in health insurance plans, population health, managed care, and utilization reviews.
• Must reside in the United States, CST or EST time zone; dedicated remote workspace with high-speed internet.

Culture & Benefits

• Comprehensive health, dental, vision insurance, life, and disability coverage.
• Retirement savings plan with company match.
• Generous time off and vacation.
• Professional development opportunities.
• Fully remote work environment.