Martin's Point Health Care
Medical Director - Health Plan - Remote
Martin's Point Health Care, Montgomery, Alabama, United States
Position: Medical Director - Health Plan, Remote
Make a Meaningful Impact on Member Health
Physician – Utilization Management & Medical Review Help shape how care is delivered—beyond the exam room. At Martin’s Point Health Care, this physician role plays a key part in ensuring members receive
clinically appropriate, high-quality care
while supporting responsible cost management. You’ll partner closely with the Health Plan Medical Director and contribute directly to our
Triple Aim
strategy. What You’ll 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 (will consider any specialty, prefer Family, Internal, or Emergency Med) 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 Martin’s 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 Martin’s 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: Meet Martin’s Point Our Locations Live and Work in Maine View Martin's Point Benefits
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
Make a Meaningful Impact on Member Health
Physician – Utilization Management & Medical Review Help shape how care is delivered—beyond the exam room. At Martin’s Point Health Care, this physician role plays a key part in ensuring members receive
clinically appropriate, high-quality care
while supporting responsible cost management. You’ll partner closely with the Health Plan Medical Director and contribute directly to our
Triple Aim
strategy. What You’ll 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 (will consider any specialty, prefer Family, Internal, or Emergency Med) 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 Martin’s 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 Martin’s 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: Meet Martin’s Point Our Locations Live and Work in Maine View Martin's Point Benefits
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