REMOTE - Medical Director - HEALTH PLAN
Martin's Point, Portland, ME, US, 04104
Duration: Full Time
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:
How to Apply:
For more information or to submit your application, please contact:
Shawn-Elise Lapomarda
Email: shawnelise.lapomarda@martinspoint.org
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 jobinquiries@martinspoint.org