Associate Medical Director

Summary Information Job #: 26644 Work Location:
US Los Angeles , CA Salary: $123500-302600 Annually Work Hours:
Monday Friday, 8:00am 5:00pm PST; additional weekends and holiday coverage prn as business needs arise Job Type:
2 Staff: Career Duration: Indefinite Posted Date:
September 17, 2025

Description

Are you passionate about evidence-based medicine and improving care for Medicare Advantage members? UCLA Health Medicare Advantage Plan is looking for a dedicated and forward-thinking Associate Medical Director to help shape the future of our plan.

In this key leadership role, you ll work closely with the UHMAP Medical Director and play a vital part in developing and guiding clinical policy that s grounded in the latest scientific research and Medicare guidelines. Your work will directly support our Health Services Department in delivering high-quality, appropriate, and patient-centered care.

What you ll do:

• Lead the development, implementation, and training of medical policies.
• Provide clinical determinations for UM (prior authorizations, concurrent reviews, appeals, grievances, peer-to-peer).
• Support day-to-day UM and Clinical Appeals operations.
• Partner with clinical and operational leaders to ensure high-quality, cost-effective care.
• Collaborate with the Pharmacy team on safe, effective medication use; participate in drug review rounds and P&T Committee.
• Contribute to interdisciplinary care team rounds for complex case management.
• Serve as clinical SME for network/provider relations and present at provider education sessions.

Salary Range: $123,500-302,600/annually

Qualifications

We re seeking a dynamic and strategic individual with:

• MD or DO degree, required
• Active, unrestricted California State Medical License, required
• Completion of residency in an adult-based primary care specialty (e.g., Internal Medicine, Family Medicine, Geriatrics), required
• Board Certification in an ABMS, ABOS, or AOA-recognized specialty (preferably Internal Medicine or Family Medicine), required
• 5 or more years of direct patient care experience post residency, required
• Minimum of 2 years medical leadership experience, required
• Minimum of 2 years of experience in Utilization Management, required
• Minimum of 2 years in developing evidence-based guidelines, medical policies, or conducting systematic literature review, required
• 2 or more years of experience working within a health plan, required
• Knowledge of Medicare Advantage experience with utilization management, quality improvement, or case management, required
• Familiarity with evidence-based guidelines, MCG/InterQual, and ICD/CPT coding, preferred
• Experience with population health and CMS STAR ratings, preferred
• Ability to lead and influence in a matrixed organizational structure
• Mastery of clinical policy development and application

Compensation Information:
$123500.00 / Annually - $302600.00 / Annually