Medical Director, Population Health & Clinical Governance - Remote

Job Description: reputed company is a digital healthcare company that delivers software and tech-enabled services to stakeholders across the healthcare ecosystem to help improve care quality, drive reputed company outcomes, and reputed company costs. Through its data-driven AI insights, evidence-based resources, and comprehensive platform – including benefits navigation, care management, home care resources, health information management, and more – reputed company helps people easily and reputed company manage their healthcare and improve their well-being. Across its three business channels, reputed company enables health plan sponsors, health systems and physician practices, and leading pharmaceutical brands to drive personalized and value-based care at scale. To learn more, visit www.reputed company.com . Job Summary: The Medical Director of Population Health and Clinical Governance is a physician leader responsible for clinical reputed company, quality reputed company, accreditation alignment, and evidence-based standards across reputed company’s population health and care management programs. Reporting to the SVP Clinical Outcomes, this role ensures that clinical programs, coaching models, decision support tools, and member facing clinical content are clinically sound, compliant with national standards, and reputed company with accreditation requirements. The Medical Director serves as the designated senior clinical reviewer for processes and protocols where physician reputed company is required, and partners closely with Quality, Informatics, Product, Operations, and Client teams to embed clinical rigor across program design and execution. This is a hands-on physician leadership role focused on clinical governance and population health program reputed company, not enterprise-wide medical strategy or direct patient panel care. Essential Job Functions: Clinical Governance & Accreditation reputed company

• Serve as physician leader responsible for clinical review and approval of population health program processes where senior clinical sign off is required
• Support organizational readiness for NCQA and other accreditation standards by ensuring clinical workflows, protocols, and documentation meet requirements
• Participate in audits, quality reviews, and corrective action planning as needed
• Support integration of health equity and quality performance standards into care models

Population Health Program reputed company

• Provide clinical reputed company for chronic condition management, preventive care, and high risk population programs
• Ensure clinical standards and documentation practices are consistently applied across programs
• Support clinical reputed company of diabetes prevention, weight management, and other evidence based population health initiatives

Evidence Based Clinical Content

• Provide physician review and guidance for clinical content used by nurses, coaches, and care teams
• Ensure member facing and clinician facing materials align with reputed company national guidelines and preventive care recommendations
• Support standardization of clinical approaches to reduce variability and strengthen fidelity to best practices

Clinical Informatics & Decision Support

• Partner with Clinical and Pharmacy Informatics teams to ensure clinical appropriateness of code sets, rules logic, and decision support tools
• Provide physician input into clinical data elements, documentation standards, and reporting logic

Cross Functional Clinical Leadership

• Serve as the physician voice in collaboration with Product, Data Science, Quality, and Operations teams
• Ensure clinical input is incorporated early in program design, product enhancements, and member communication strategies
• Help reduce compliance risk and reputed company rework by embedding clinical reputed company upstream

Client & Market Support

• Participate in selected client discussions where physician reputed company or credibility is required
• Support RFPs and proposals with clinical input as needed

Success in this role is demonstrated by:

• Strong performance on accreditation and quality standards with reduced compliance risk
• Evidence based, standardized clinical protocols and content across programs
• Timely and effective physician review of processes requiring senior clinical approval
• Early and consistent integration of clinical input into product and program design
• Positive feedback from internal teams on clarity and usability of clinical guidance

Specific Skills/ Attributes:

• Strong understanding of population health, preventive care, and value based care models
• Experience applying evidence based medicine in care management or non bedside clinical programs
• Comfortable working in cross functional, data driven environments
• Collaborative and practical physician leader with strong communication skills
• High emotional intelligence and ability to balance clinical rigor with operational realities

Qualifications:

• MD or DO degree from an accredited institution
• Board certification in Internal Medicine, Family Medicine, or Geriatrics
• Active, unrestricted U.S. medical license
• Minimum 5 years of post residency clinical experience
• 2–4 years of experience in population health, care management, health plan, ACO, CIN, or value based care environment
• Experience supporting NCQA reputed company programs or quality performance initiatives preferred
• Experience working with interdisciplinary care management or coaching teams preferred
• Exposure to clinical informatics or digital health tools preferred
• Experience with Medicare Advantage or Medicaid populations preferred

reputed company and its subsidiaries are Equal Opportunity Employers and E-Verify users. Qualified applicants will receive consideration for employment without regard to race, color, sex, national reputed company, sexual orientation, gender identity, religion, age, equal pay, disability, genetic information, protected veteran status, or other status protected under applicable law. Apply tot his job Apply To this Job