Medicare Medical Director (MD)

We believe every candidate deserves thoughtful consideration. That’s why we do not use AI or automated systems to review applications. Every application is reviewed by a real human member of our team. Because we take the time to give each submission the attention it deserves, our review process may take a little longer — and we genuinely appreciate your patience as we work through applications carefully and respectfully. 

While we encourage all interested applicants to apply, we do give priority to those who live in, or near, our service counties: Santa Cruz, Monterey, Merced, San Benito, and Mariposa. Our mission of accessible, quality health care guided by local innovation leads everything we do, and having team members who are connected to the communities we serve strengthens our ability to deliver on that commitment. 

*This is a hybrid position with the expectation to work in our service area(s) 2-3 days per month. The Alliance service area includes Merced, Santa Cruz, Monterey, San Benito, and Mariposa counties. 

We have an opportunity to join the Alliance as the Medicare Medical Director (MD). 

Reporting to the Chief Medical Officer, this position:

• Acts as the Alliance’s Medicare Dual Eligible Special Needs Plan (D-SNP) clinical subject matter expert
• Provides specialized clinical D-SNP leadership within a variety of Health Services functional areas
• Develops and improves relationships with internal and external stakeholders, including the professional medical community, and maintains and enhances communications with similar Health Plan organizations
• Participates in all aspects of regulatory compliance related to D-SNP and Health Services functions

• Enjoys a fast-paced, demanding environment that requires critical thinking to develop and implement effective solutions in a timely manner 
• Is dedicated to caring for Medicare and/or Medicaid patients while addressing the social determinants of health
• Works with a broad and diverse group of stakeholders to problem solve and build cutting-edge programs
• Has the latitude to think broadly, make operational and strategic decisions, and oversee the implementation and continuous process improvement related to key internal and external priorities 

To read the full position description, and list of requirements click here. 

• Knowledge of:
  • The needs of the Medicare population and/or Medicare Plan administration
  • The Medicare D-SNP program and related regulations, CMS D-SNP STARS Rating System, and managed care
  • Medical programs administration, quality improvement, and/or informatics
  • Data collection and management practices, as related to utilization and quality of medical care
  • Promoting and applying change management principles
• Ability to:
  • Provide clinical oversight and leadership of the Medicare D-SNP program
  • Analyze issues and think critically to ensure success in leading system change, make informed operational and strategic decisions, and oversee implementation and continuous process improvement related to key internal and external priorities
  • Audit, analyze, and assess medical records and other health care data
  • Interpret regulations, legal and contractual language, policies, and procedures
• Education and Experience:
  • Doctor of Medicine, current license to practice medicine issued by the State of California, Board certification in a specialty recognized by the American Board of Medical Specialties, and a minimum of three years of experience as an attending physician with the Medicare population or three years of experience as an attending physician which included a minimum of two years of Medicare Plan administration experience; or an equivalent combination of education and experience may be qualifying

• We are in a hybrid work environment and we anticipate that the interview process will take place remotely via Microsoft Teams.
• While some staff may work full telecommuting schedules, attendance at quarterly company-wide events or department meetings will be expected.
• In-office or in-community presence may be required for some positions and is dependent on business need. Details about this can be reviewed during the interview process.

COMPENSATION INFORMATION 

• Zone 1 Pay Range: $340K - $408K
  Typical areas in Zone 1: Santa Cruz, San Benito, and Monterey Counties, Bay Area, Sacramento, Los Angeles and San Diego areas 

• Zone 2 Pay Range: $320K - $385K
  Typical areas in Zone 2: Mariposa and Merced Counties, Fresno area, Bakersfield,  Eastern California, San Luis Obispo area, and the Central Valley (except  Sacramento) 

The applicable salary ranges are based on work location and are aligned to a zone according to the cost of labor in your area. All ranges are subject to change in the future. We are happy to provide the full compensation range for the role, answer any questions that you have, or share the applicable pay zone for your location if it’s not one of the typical areas listed. You can reach out to careers@thealliance.health, and a member from our Talent Acquisition team will be in touch. 

The hiring ranges represent a good‑faith estimate of what we expect to pay for this role upon hire and are not the full compensation ranges. Employees typically have opportunities for growth within the full compensation range over time based on performance and merit. Final compensation will be determined by our compensation philosophy, analysis of the selected candidate's qualifications (direct or transferable experience related to the position, education, or training), as well as other factors (internal equity, market factors, and geographic location). 

We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us. 

The Alliance is an equal employment opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender perception or identity, national origin, age, marital status, protected veteran status, or disability status. We are an E-Verify participating employer

Join us at Central California Alliance for Health (the Alliance) is an award-winning regional Medi-Cal managed care plan that provides health insurance for children, adults, seniors and people with disabilities in Mariposa, Merced, San Benito and Santa Cruz counties. We currently serve more than 418,000 members. To learn more about us, take a look at our Fact Sheet.

At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for any type of employer supported or provided sponsorship.