Senior Medical Director - Policy & Outcomes

Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience. Reporting to the Vice President of Health Services, the Senior Medical Director Policy & Outcomes (Sr. Medical Director - P&O) is responsible for strategic oversight of IEHP Medical Policies and clinical leadership around member health outcomes. The Sr. Medical Director – P&O oversees day‑to‑day operations related to developing, executing, leading, and updating guidelines, policies, clinical pathways, and communications that enable effective health outcomes and health plan performance according to DHCS, DMHC, CMS, and CCA clinical requirements. This leader serves as the accountable medical leader for quality management, grievance and appeals, delegation oversight, and population health management, and works with cross‑functional departments to monitor policy outcomes through reporting, metrics, initiatives, and improvement activities. The position also leads regulatory audits for all relevant domains.

Key Qualifications

• Valid California Driver’s License (preferred)
• Comprehensive knowledge of:
• Managed Care principles
• Administrative practices and procedures (including but not limited to credentialing, risk management, rules and regulations, policies and standards related to managed care)
• Principles of effective supervision and organization; methods, techniques, practices, principles, and literature in the broad field of medical sciences
• Principles of medical practice in a variety of settings (inpatient, outpatient, sub‑acute, etc.)
• Familiarity with local healthcare organizations and/or local practice experience (preferred)
• Highly organized
• Effective communication skills
• Proficient with Microsoft Word, Excel, and Access
• Assertive communicator
• Experience demonstrating effective leadership of physicians and clinical staff
• Track record of leading with accountability (required)
• Travel within California (required)

Education & Requirements

• Seven (7) years of post‑residency experience in a recognized medical specialty or practice, including at least three (3) years of medical administrative experience
• Minimum of five (5) years of managed‑care or health‑plan leadership experience with a proven track record of leading high‑performing physician teams
• Experience working with clinical practice guidelines and evidence‑based criteria sets
• Exposure to working with regulatory agencies
• Medical Director for an IPA, medical group, or CA HMO (highly desirable)
• Medical specialty/practice experience preferably in California
• Doctorate of Medicine from an accredited institution (required)
• Certification by one of the American Specialty Boards (required)
• Completion of an accredited residency program (required)
• Active, unrestricted, and unencumbered Physician’s and Surgeon’s Certificate issued by the State of California (required)
• Physician certified in a state other than California may be employed prior to receipt of California certification, provided an application is filed in the state of California before the date of appointment (required)

Benefits

• Competitive salary
• Hybrid schedule
• State‑of‑the‑art fitness center on site
• Medical insurance including dental and vision
• Life, short‑term, and long‑term disability options
• Career advancement opportunities and professional development
• Wellness programs promoting a healthy work‑life balance
• Flexible Spending Account – Health Care/Childcare
• CalPERS retirement
• 457(b) option with a contribution match
• Paid life insurance for employees
• Pet care insurance

Salary

• $280,841.60 USD annually – $393,182.40 USD annually