REMOTE - Medical Director - HEALTH PLAN
Position: Medical Director - Health Plan, Remote
Make a Meaningful Impact on Member Health
Physician - Utilization Management & Medical Review
Help shape how care is deliveredbeyond the exam room.
At Martins Point Health Care, this physician role plays a key part in ensuring members receive clinically appropriate, high-quality care while supporting responsible cost management. Youll partner closely with the Health Plan Medical Director and contribute directly to our Triple Aim strategy.
What Youll Do
• Perform medical necessity reviews, including disputes and appeals
• Participate in case reviews focused on quality, safety, and outcomes
• Support utilization, care management, and disease management programs
• Ensure compliance with NCQA, CMS, and TRICARE requirements
• Contribute to medical policy development
• Collaborate with Informatics, Network Management, and Medical Economics
• Use data to assess network provider utilization and support improvement
• Help manage and strategically deploy ACOs
• Support risk adjustment activities as needed
• Track and support key metrics (MLR, utilization trends, HEDIS, QI)
What You Bring
• MD or DO
• Active, unrestricted medical license (or eligibility) in ME or NH
• Board certified with direct patient care experience
• Health plan or utilization management experience
• Strong clinical judgment and analytical skills
• Ability to build trusted relationships across teams
• Alignment with Martins Point values and mission
Why This Role
• Physician-led, mission-driven work
• Systems-level impact on quality and cost
• Collaborative, data-informed environment
• Opportunity to influence care for entire populations
This is a remote position with occasional travel to Portland, Maine.
Ready to make a difference? Join us in ensuring every member receives the right care, at the right time, in the right place.
Why Join Martins Point?
• Mission-driven organization focused on improving community health
• Strong culture of respect, collaboration, and work-life balance
• Certified Great Place to Work since 2015
• Comprehensive benefits package
Explore More:
• Meet Martins Point
• Our Locations
• Live and Work in Maine
• View Martin's Point Benefits
How to Apply:
For more information or to submit your application, please contact:
Shawn-Elise Lapomarda
Email:
[email protected]
We are proud to be an equal opportunity/affirmative action employer. This position is not eligible for immigration sponsorship. We are an equal opportunity/affirmative action employer.
Martin's Point complies with federal and state disability laws and makes reasonable accommodations for applicants and employees with disabilities. If a reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact [email protected]
Remote
About the Company:
Martin's Point
Apply tot his job
Apply To this Job
Make a Meaningful Impact on Member Health
Physician - Utilization Management & Medical Review
Help shape how care is deliveredbeyond the exam room.
At Martins Point Health Care, this physician role plays a key part in ensuring members receive clinically appropriate, high-quality care while supporting responsible cost management. Youll partner closely with the Health Plan Medical Director and contribute directly to our Triple Aim strategy.
What Youll Do
• Perform medical necessity reviews, including disputes and appeals
• Participate in case reviews focused on quality, safety, and outcomes
• Support utilization, care management, and disease management programs
• Ensure compliance with NCQA, CMS, and TRICARE requirements
• Contribute to medical policy development
• Collaborate with Informatics, Network Management, and Medical Economics
• Use data to assess network provider utilization and support improvement
• Help manage and strategically deploy ACOs
• Support risk adjustment activities as needed
• Track and support key metrics (MLR, utilization trends, HEDIS, QI)
What You Bring
• MD or DO
• Active, unrestricted medical license (or eligibility) in ME or NH
• Board certified with direct patient care experience
• Health plan or utilization management experience
• Strong clinical judgment and analytical skills
• Ability to build trusted relationships across teams
• Alignment with Martins Point values and mission
Why This Role
• Physician-led, mission-driven work
• Systems-level impact on quality and cost
• Collaborative, data-informed environment
• Opportunity to influence care for entire populations
This is a remote position with occasional travel to Portland, Maine.
Ready to make a difference? Join us in ensuring every member receives the right care, at the right time, in the right place.
Why Join Martins Point?
• Mission-driven organization focused on improving community health
• Strong culture of respect, collaboration, and work-life balance
• Certified Great Place to Work since 2015
• Comprehensive benefits package
Explore More:
• Meet Martins Point
• Our Locations
• Live and Work in Maine
• View Martin's Point Benefits
How to Apply:
For more information or to submit your application, please contact:
Shawn-Elise Lapomarda
Email:
[email protected]
We are proud to be an equal opportunity/affirmative action employer. This position is not eligible for immigration sponsorship. We are an equal opportunity/affirmative action employer.
Martin's Point complies with federal and state disability laws and makes reasonable accommodations for applicants and employees with disabilities. If a reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact [email protected]
Remote
About the Company:
Martin's Point
Apply tot his job
Apply To this Job