Medical Director, Population Health – Clinical Governance

This is a fully remote position, open to applicants in United States.

📋 Description

• Act as the physician leader responsible for the clinical evaluation and endorsement of population health program processes that necessitate senior clinical approval.

• Facilitate preparedness for NCQA and other accreditation criteria.

• Engage in audits, quality assessments, and corrective action planning.

• Incorporate health equity and quality performance benchmarks into care models.

• Provide clinical supervision for chronic condition management, preventive care, and programs targeting high-risk populations.

• Maintain uniform clinical standards and documentation practices across all programs.

• Uphold the clinical integrity of diabetes prevention, weight management, and other evidence-based initiatives.

• Evaluate and direct clinical content for nurses, coaches, and care teams.

• Ensure that materials intended for members and clinicians are consistent with national guidelines.

• Standardize clinical approaches and enhance adherence to best practices.

• Collaborate with Clinical and Pharmacy Informatics teams on code sets, rules logic, and decision-support tools.

• Offer physician insights into clinical data elements, documentation standards, and reporting logic.

• Work in partnership with Product, Data Science, Quality, and Operations teams.

• Integrate clinical insights into program design, product improvements, and member communication strategies.

• Take part in select client discussions and assist with RFPs and proposals by providing clinical input.

⛳️ Requirements

• MD or DO degree from a recognized institution.

• Board certification in Internal Medicine, Family Medicine, or Geriatrics.

• Active, unrestricted U.S. medical license.

• A minimum of 5 years of clinical experience post-residency.

• 2–4 years of experience in population health, care management, health plan, ACO, CIN, or value-based care settings.

• Preferred experience in supporting NCQA-aligned programs or quality performance initiatives.

• Preferred experience working with interdisciplinary care management or coaching teams.

• Familiarity with clinical informatics or digital health tools is preferred.

• Preferred experience with Medicare Advantage or Medicaid populations.

• Strong comprehension of population health, preventive care, and value-based care models.

• Experience applying evidence-based medicine in care management or non-bedside clinical programs.

• Comfortable operating in cross-functional, data-driven environments.

• A collaborative and practical physician leader with excellent communication skills.

• High emotional intelligence with the ability to balance clinical rigor against operational realities.

🏝️ Benefits

• Equal Opportunity Employer protections.

• E-Verify participation.