Market Medical Officer, CentralNew$291K–$381K
The opportunity
Hi, we're Oscar. We're hiring a Market Medical Director, Central to join our Clinical Affairs team.
What you'll do
Drive performance of key clinical metrics for trend management and market: performance of plans in their region including but not limited to ED/K, APK, ALOS and others in partnership with market P&L leadership.
Work in partnership with Med Econ to identify market based utilization trends: and flares and develop solutions to address key drivers to reduce overall spend.
Build strategic partnerships with health systems, physician groups, and: community providers to align incentives and lower the total cost of care.
Serve as regional clinical partner across internal teams, partnering closely: with Affordability, Utilization Management (UM), Care Management (CM), Claims, and others to drive regional performance goals.
Partner with Network Contracting leadership to guide clinical initiatives: that enhance provider alignment, care quality, and clinical outcomes across the region.
Proactively identify and resolve regional network gaps and access barriers to: advance equitable, high-quality care across all member populations.
What they're looking for
- Collaborate with regulatory agencies and compliance teams to ensure regional: network adequacy and quality programs comply with state and federal requirements, translating policy changes into proactive operational strategy that protect member access and organizational performance.
- Serve as the point of accountability for regional escalations, including: internal/external appeals, provider and member grievances, and complex case management scenarios.
- Compliance with all applicable laws and regulations.
- Other responsibilities as assigned.
