Medicare Medical Director (MD)
Company: Central California Alliance for Health
Location: San Jose
Posted on: February 17, 2026
|
|
|
Job Description:
Job Description Job Description OUR COMMITMENT TO A HUMAN HIRING
PROCESS We believe every candidate deserves thoughtful
consideration. That's why we do not use AI or automated systems to
review applications. Every application is reviewed by a real human
member of our team. Because we take the time to give each
submission the attention it deserves, our review process may take a
little longer — and we genuinely appreciate your patience as we
work through applications carefully and respectfully. SERVICE AREA
PREFERENCE While we encourage all interested applicants to apply,
we do give priority to those who live in, or near, our service
counties: Santa Cruz, Monterey, Merced, San Benito, and Mariposa.
Our mission of accessible, quality health care guided by local
innovation leads everything we do, and having team members who are
connected to the communities we serve strengthens our ability to
deliver on that commitment. *This is a hybrid position with the
expectation to work in our service area(s) 2-3 days per month. The
Alliance service area includes Santa Cruz, Monterey, Merced, San
Benito, and Mariposa counties. We have an opportunity to join the
Alliance as the Medicare Medical Director (MD). WHAT YOU'LL BE
RESPONSIBLE FOR Reporting to the Chief Medical Officer, this
position: Acts as the Alliance's Medicare Dual Eligible Special
Needs Plan (D-SNP) clinical subject matter expert Provides
specialized clinical D-SNP leadership within a variety of Health
Services functional areas Develops and improves relationships with
internal and external stakeholders, including the professional
medical community, and maintains and enhances communications with
similar Health Plan organizations Participates in all aspects of
regulatory compliance related to D-SNP and Health Services
functions THE IDEAL CANDIDATE Enjoys a fast-paced, demanding
environment that requires critical thinking to develop and
implement effective solutions in a timely manner Is dedicated to
caring for Medicare and/or Medicaid patients while addressing the
social determinants of health Works with a broad and diverse group
of stakeholders to problem solve and build cutting-edge programs
Has the latitude to think broadly, make operational and strategic
decisions, and oversee the implementation and continuous process
improvement related to key internal and external priorities WHAT
YOU'LL NEED TO BE SUCCESSFUL To read the full position description,
and list of requirements click here. Knowledge of: The needs of the
Medicare population and/or Medicare Plan administration The
Medicare D-SNP program and related regulations, CMS D-SNP STARS
Rating System, and managed care Medical programs administration,
quality improvement, and/or informatics Data collection and
management practices, as related to utilization and quality of
medical care Promoting and applying change management principles
Ability to: Provide clinical oversight and leadership of the
Medicare D-SNP program Analyze issues and think critically to
ensure success in leading system change, make informed operational
and strategic decisions, and oversee implementation and continuous
process improvement related to key internal and external priorities
Audit, analyze, and assess medical records and other health care
data Interpret regulations, legal and contractual language,
policies, and procedures Education and Experience: Doctor of
Medicine, current license to practice medicine issued by the State
of California, Board certification in a specialty recognized by the
American Board of Medical Specialties, and a minimum of three years
of experience as an attending physician with the Medicare
population or three years of experience as an attending physician
which included a minimum of two years of Medicare Plan
administration experience; or an equivalent combination of
education and experience may be qualifying OTHER INFORMATION We are
in a hybrid work environment and we anticipate that the interview
process will take place remotely via Microsoft Teams. While some
staff may work full telecommuting schedules, attendance at
quarterly company-wide events or department meetings will be
expected. In-office or in-community presence may be required for
some positions and is dependent on business need. Details about
this can be reviewed during the interview process. COMPENSATION
INFORMATION The hiring ranges below represent a good?faith estimate
of what we expect to pay for this role upon hire and are not the
full compensation ranges. Employees typically have opportunities
for growth within the full compensation range over time based on
performance and merit. Final compensation will be determined by our
compensation philosophy, analysis of the selected candidate's
qualifications (direct or transferable experience related to the
position, education, or training), as well as other factors
(internal equity, market factors, and geographic location). The
applicable salary ranges are based on work location and are aligned
to a zone according to the cost of labor in your area. All ranges
are subject to change in the future. We are happy to provide the
full compensation range for the role, answer any questions that you
have, or share the applicable pay zone for your location if it's
not one of the typical areas included below. You can reach out to
careers@thealliance.health, and a member from our Talent
Acquisition team will be in touch. Typical areas in Zone 1: Santa
Cruz, San Benito, and Monterey Counties, Bay Area, Sacramento, Los
Angeles and San Diego areas Typical areas in Zone 2: Mariposa and
Merced Counties, Fresno area, Bakersfield, Eastern California, San
Luis Obispo area, and the Central Valley (except Sacramento) Zone 1
(Monterey, San Benito and Santa Cruz) $350,000—$408,000 USD Zone 2
(Mariposa and Merced) $330,000—$385,000 USD OUR BENEFITS Medical,
Dental and Vision Plans Ample Paid Time Off 12 Paid Holidays per
year 401(a) Retirement Plan 457 Deferred Compensation Plan Robust
Health and Wellness Program Onsite EV Charging Stations And many
more ABOUT US We are a group of over 500 dedicated employees,
committed to our mission of providing accessible, quality health
care that is guided by local innovation. We feel that our work is
bigger than ourselves. We leave work each day knowing that we made
a difference in the community around us. The Alliance is an equal
employment opportunity employer. Qualified applicants will receive
consideration for employment without regard to race, color,
religion, sex (including pregnancy), sexual orientation, gender
perception or identity, national origin, age, marital status,
protected veteran status, or disability status. We are an E-Verify
participating employer Join us at Central California Alliance for
Health (the Alliance) is an award-winning regional Medi-Cal managed
care plan that provides health insurance for children, adults,
seniors and people with disabilities in Mariposa, Merced, San
Benito and Santa Cruz counties. We currently serve more than
418,000 members. To learn more about us, take a look at our Fact
Sheet . At this time the Alliance does not provide any type of
sponsorship. Applicants must be currently authorized to work in the
United States on a full-time, ongoing basis without current or
future needs for any type of employer supported or provided
sponsorship.
Keywords: Central California Alliance for Health , Danville , Medicare Medical Director (MD), Healthcare , San Jose, California