Medical Director – Pediatrics

Are you an accomplished physician executive with a passion for driving systemic clinical excellence and healthcare transformation? We are seeking a visionary, board-certified pediatric leader to step into the role of Medical Director – Pediatrics for a nationally recognized healthcare organization. In this high-impact executive position, you will provide overarching clinical leadership, quality oversight, and strategic medical policy guidance to ensure high-quality, evidence-based, and cost-effective care across an expansive network. Collaborating closely with clinical and operational leaders, you will champion peer reviews, utilization management, and provider engagement initiatives. This long-term opportunity allows you to leverage your extensive clinical expertise to shape pediatric healthcare delivery on a national scale, all from a flexible remote environment.

Clinical Leadership & Quality Governance

Clinical Oversight: Provide strategic clinical leadership and medical policy guidance for comprehensive pediatric healthcare services across multiple business units.

Quality Assurance: Lead robust peer review activities, clinical governance, quality reviews, and complex medical necessity evaluations.

Policy Development: Support the formulation, optimization, and implementation of evidence-based clinical policies, procedures, and medical guidelines.

Performance Partnership: Partner dynamically with operational and clinical leadership to monitor, evaluate, and improve provider performance and patient outcomes.

Metric Evaluation: Track and analyze key performance indicators (KPIs), utilization management data, and HEDIS/quality metrics to drive continuous organizational success.

Compliance & Accreditation: Support rigorous accreditation processes, regulatory compliance, and organization-wide Quality Improvement (QI) initiatives.

Stakeholder Engagement: Collaborate with internal and external stakeholders to substantially enhance both the patient and provider experience.

Strategic Planning: Act as a trusted physician executive, participating in long-term strategic planning and multidisciplinary corporate initiatives.

Other duties as assigned.

Required Qualifications

Educational Credentials: Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO) degree.

Board Certification: Current Board Certification in Pediatrics.

Licensure: An active, unrestricted state medical license.

Clinical Depth: Minimum of 10 years of hands-on clinical physician experience in pediatrics.

Leadership Experience: Minimum of 5 years of dedicated physician leadership experience in a role such as Medical Director, Associate Medical Director, Chief Medical Officer, Department Chair, or Service Line Director.

Quality Frameworks: Proven experience directing peer reviews, quality improvement structures, and provider performance management.

Core Competencies: Exceptional communication, collaborative relationship-building, and executive leadership skills.

Desired Qualifications

Managed Care Expertise: Prior leadership experience within a Health Plan, Managed Care Organization (MCO), or Integrated Delivery Network.

Utilization & Review: Direct experience handling Utilization Management, Medical Necessity Reviews, and credentialing oversight.

Accreditation Knowledge: Strong familiarity with NCQA, HEDIS, Joint Commission, URAC, or related accreditation bodies.

Modern Care Delivery: Background in Population Health systems, Value-Based Care models, and leading multidisciplinary clinical teams .

Location and Work Type

Work Type: Full-Time, 40 hours per week. Long-term contract opportunity.

Work Setting: 100% Remote (Candidates must reside within approved states).

Hourly Rate: $140.00 – $145.00 per hour.

Perks: Enjoy the ultimate work-life balance with a fully remote schedule while making a profound, macro-level impact on pediatric healthcare systems nationwide.