Regional Medical Director- (Philadelphia/Baltimore)

Job Summary

This position is responsible for assigned aspects of medical policies and programs. Performs medical reviews and interacts with the provider communities for assigned areas. Provides advanced clinical leadership across medical management programs, integrating traditional utilization review with strategic population health, value-based care, and provider-performance initiatives. Aligns medical policy expertise with forward-leaning clinical strategy to influence quality, Stars-related performance, affordability, risk adjustment accuracy, and market-level outcomes.

About the Role

CareAllies empowers employees with curated development plans that foster growth and promote rewarding, fulfilling careers. This position is remote and located in Philadelphia and Baltimore.

Responsibilities

• Performs medical reviews and interacts with the provider communities for assigned areas.
• Provides advanced clinical leadership across medical management programs, integrating traditional utilization review with strategic population health, value-based care, and provider-performance initiatives.
• Aligns medical policy expertise with forward-leaning clinical strategy to influence quality, Stars-related performance, affordability, risk adjustment accuracy, and market-level outcomes.

Requirements

• Physician with a current and unrestricted physician license in a state or territory of the United States.
• Maintain Board Certification as a M.D. or D.O. (by a specialty board approved by the American Board of Medical Specialties (doctors of medicine); or the Advisory Board of Osteopathic Specialists (doctors of osteopathic medicine))
• 5 years of clinical experience
• Analytical and communication skills
• Strategic thinking skills

Qualifications

• Ability to travel
• 3 years Managed Care experience
• IPA (independent Physician Association) MSO or Value Based Enablement Organization Experience
• Advanced skills in clinical interpretation, communication, data-driven strategy, and collaborative leadership
• Experience with Stars performance, risk adjustment education, or provider engagement
• Experience in matrixed environments and cross-functional clinical leadership

Skills

• Ability to travel
• Advanced skills in clinical interpretation, communication, data-driven strategy, and collaborative leadership
• Experience with Stars performance, risk adjustment education, or provider engagement
• Experience in matrixed environments and cross-functional clinical leadership

Benefits

We offer a robust total rewards package for full-time employees including health and wellness benefits, 401(k) savings plan, pension plan, a minimum of 15 days’ of paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives.

Pay

The salary offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. Min To Max Range $191,500.00 - $355,600.00 Exact compensation may vary based on skills, experience, and location.