REMOTE - Associate Medical Director, Health Plan

Join Martin’s Point Health Care, an innovative, not-for-profit organization recognized as a Great Place to Work since 2015. Our mission is simple: people caring for people. Together, we provide care and coverage to communities across Maine and beyond—transforming health care while building healthier communities.

We’re seeking a Medical Director to provide clinical leadership for our Health Plans. In this role, you’ll partner with leaders across Utilization and Care Management, Health Management, Compliance, Network Management, and beyond to ensure high-quality, cost-effective care for our members. You’ll help shape clinical programs, influence quality and performance outcomes, and guide medical policy development.

What you’ll do:

• Lead clinical oversight for utilization and care management

• Review medical necessity, appeals, and disputes for clinical appropriateness

• Drive quality improvement and support accreditation standards (NCQA, CMS, TRICARE)

• Partner with Informatics and Medical Economics on provider performance and cost management

• Contribute to ACO strategy, risk adjustment, and overall Health Plan performance metrics

What we’re looking for:

• Board-certified physician with clinical practice experience

• Background in health plan leadership, utilization management, or Medicare Advantage/TRICARE preferred

• Strong analytical, strategic, and relationship-building skills

• Active medical license (Maine, NH, or eligible to obtain)

At Martin’s Point, we value trust, respect, continuous learning, and even a little fun. If you’re a physician leader ready to make an impact on health care delivery at the system level, we’d love to meet you.

Apply today and discover why people love working at Martin’s Point.

This position is not eligible for immigration sponsorship.

We are an equal opportunity/affirmative action employer.

Martin's Point Health Care is an innovative not-for-profit health care organization offering high-quality, affordable health care and coverage to the people of Maine and throughout New England.

We have seven health care centers in Maine and New Hampshire offering primary and specialty care to those with most major health insurance plans. Our collaborative, team based approach has created an environment where each patient is treated with warmth, care and concern.

Martin's Point also administers two health insurance plans: Generations Advantage--with the only 5-Star Medicare Advantage plans in New England, and the US Family Health Plan for active duty military families and retirees throughout most of northern New England and New York.

We believe that understanding both the clinical and health plan administrative side gives us the insight we need to make meaningful improvements to the health care system. Martin's Point is dedicated to creating a community of healthy people through authentic relationships and trust.

Talk to us and find out the many reasons why Great Place to Work® and Fortune magazine have named Martin’s Point Health Care one of the 2018 Best Workplaces in Health Care!

Martin’s Point Health Care is an Equal Opportunity Employer.