Medical Director Physician

Job Responsibilities

• Provide program-wide clinical guidance across multiple medical management domains including Utilization Management, Case Management, Quality, and Public Health.
• Lead and participate in quality committees and collaborative safety initiatives.
• Review member cases for appropriateness and quality of care; document findings in CareRadius and other health systems.
• Conduct peer-to-peer discussions with network providers and internal stakeholders.
• Develop and implement corrective action plans related to clinical quality or provider performance.
• Collaborate closely with TriWest teams such as Clinical Operations, Data Analytics, and General Counsel.
• Provide clinical expertise on new technologies, treatment protocols, and population health initiatives.
• Interact with veterans and beneficiaries to support satisfaction and outcomes.
• Stay current with required licensure, board certification, and federal medical standards.

Requirements

• Doctor of Medicine (MD) or Doctor of Osteopathy (DO) from an accredited medical school.
• Active, unrestricted license to practice medicine in the United States.
• Board certification or board eligibility through a recognized specialty board.
• U.S. Citizenship.
• Favorable background investigation through the Department of Defense (DoD).
• Minimum of 5 years of medical practice experience.
• 3+ years of experience in managed care environments.
• Preferred: Experience working with TRICARE, Veterans Affairs, or other federal health plans.
• Advanced degree in management (MPA, MBA, MHA, MPH).
• Corporate-level leadership experience.
• Experience using InterQual and/or similar evidence-based criterial to assess medical interventions, procedures and treatments.

About the Role

This remote-based civilian position is an outstanding chance to make a meaningful contribution to the healthcare of veterans and military beneficiaries while benefiting from work-life flexibility, professional collaboration, and impactful leadership. Join us in leading high-quality care initiatives for those who have served our country, with a focus on system-wide clinical improvement, peer collaboration, and mission-driven support!

Company Overview

Spectrum Healthcare Resources (SHR) was established in 1988 to deliver systems and processes designed to meet the unique needs of Military and VA Health Systems. SHR is a leading organization that provides physician and clinical staffing and management services to United States Military Treatment Facilities, VA clinics and other Federal Agencies through various contracting vehicles. A Joint Commission Health Care Staffing Services firm, SHR is the military staffing division of TeamHealth, a Nationwide organization that serves 850 civilian and military hospitals with a team of 9,600 affiliated health care professionals. EOE/Disabled/Veterans