Job Summary We are seeking a dynamic and experienced Senior Medical Director focused on Medicare services to lead our medical team. In this pivotal role, you will act as the primary liaison between administration and medical staff, ensuring the successful development and execution of policies and procedures that enhance medical staff services. You will maintain an up-to-date understanding of relevant national, state, and local laws and standards affecting our medical and allied health staff. Key Responsibilities Facilitate recruitment, hiring, and training of medical staff as necessary. Analyze data to uncover opportunities for medical cost savings and enhance quality of care. Ensure compliance with regulatory and accreditation standards, addressing inquiries and issues from regulatory bodies. Lead the medical team in providing expert physician leadership in various clinical activities, including prior authorization and case management. Guarantee that authorization decisions are made by qualified medical personnel without fiscal or administrative bias. Supervise and mentor Medical Directors, fostering an environment of growth and professionalism. Develop and revise medical policies and procedures to align with best practices. Conduct peer reviews to uphold high standards of care and accountability. Qualifications Required Education: Doctorate Degree in Medicine Board Certified or eligible in a primary care specialty Required Experience, Knowledge, Skills & Abilities: A minimum of 10 years relevant experience, with at least 5 years in clinical practice and 3 years in HMO/Managed Care, or 5 years as a Molina Medical Director. Proven management experience in Utilization/Quality Program oversight. Demonstrated leadership capabilities. Experience in peer review, medical policy and procedure development, and provider contracting. Strong clinical knowledge and the ability to stay current with medical advancements. Exceptional management and communication skills, with a talent for consensus-building and collaborative work. In-depth understanding of applicable state, federal, and third-party regulations. Required License, Certification, Association: Current State Medical License without restrictions (free from sanctions by Medicaid or Medicare). Preferred Education: Master's in Business Administration, Public Health, or Healthcare Administration. Preferred License, Certification, Association: Board Certification in Pediatrics, Family Practice, Ob/Gyn, or Internal Medicine. Physical Demands: The working environment is generally favorable, with adequate lighting and temperature. Most tasks will be performed in an office environment with limited exposure to unpleasant or hazardous conditions. Candidates must be capable of sitting for extended periods. Reasonable accommodations may be provided to assist individuals with disabilities in fulfilling essential job functions. If you are currently employed by Molina Healthcare and are interested in this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package and is proud to be an Equal Opportunity Employer (EOE) M/F/D/V.