Inland Empire Health Plan
1001-5000 employees
Health Care
Insurance
Managed Health Care
About Inland Empire Health Plan
Inland Empire Health Plan (IEHP) is a public, not-for-profit health plan that provides comprehensive health care coverage to residents of Riverside and San Bernardino counties in California. Founded in 1996, IEHP offers Medi-Cal, Medicare, and Dual Eligible Special Needs Plans, focusing on improving health outcomes through coordinated care and community partnerships. The organization is committed to delivering quality, accessible, and affordable health care services to underserved populations, emphasizing preventive care and member engagement. IEHP is recognized for its innovative programs and dedication to enhancing the health and well-being of its members.
5 months ago
Medical Director- Hospital & Ancillary Relations
Full-time
Mid Level
Medical Director- Hospital & Ancillary Relations
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Description
- The Medical Director of Hospital & Ancillary Relations serves as a physician advisor / dyad partner to other members of the Hospital and Ancillary Relations leadership team in providing clinical leadership and guidance toward operational and quality improvement activities aimed at achieving the strategic initiatives set forth by Plan administration as they relate to hospital and ancillary services. The Medical Director of Hospital and Ancillary Relations leverages their knowledge and experience in health care operations and team dynamics to effectively collaborate with health plan and provider leaders and departments, soliciting input and support in identifying and implementing practice activities and setting appropriate standards to improve care delivery within the hospital and ancillary setting.
- Key responsibilities include identifying clinical practice opportunities, providing clinical leadership for hospital and ancillary care goals, developing relationships with clinical leadership teams, educating clinicians on best practices, maintaining knowledge of social, medical, and fiscal factors affecting services, organizing and monitoring provider activities, recommending research activities, promoting hospice and post-acute services, developing educational programs, providing feedback to policymakers, monitoring quality of care, utilizing quality assessment findings to improve contracts and policies, ensuring appropriate provider care, collaborating on utilization management, reviewing denials and appeals, and performing other duties to support health plan operations.
- Qualifications include five years of post-residency experience in relevant specialties, experience in quality and utilization management, strong product and program management skills, a medical degree (MD or DO), and an active California medical license. Key qualifications also include knowledge of healthcare regulations, excellent communication and leadership skills, and a valid California driver’s license preferred. The position is on a hybrid work schedule based in Rancho Cucamonga, CA.
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Requirements
- Five (5) years of post-residency or licensure experience in a recognized specialty such as Family Medicine, Internal Medicine, Pediatrics, or Emergency Medicine
- Experience in quality, care coordination, utilization management in inpatient, ACO, or FQHC environments
- Strong product and program management experience, including product delivery and management consulting
- At least three (3) years of administrative experience in clinical settings including inpatient, outpatient, and community-based care
- Medical Degree (MD, DO) from an accredited institution
- Possession of an active, unrestricted Physician’s and Surgeon’s Certificate issued by the California Medical Board
- Valid California Driver’s License (preferred)
- Knowledge of medical practice, clinical operations, healthcare regulations (DHCS, NCQA, CMS, TJC/DNV), and healthcare trends
- Excellent Word, Excel, PowerPoint skills, and strong communication skills
- Proven ability to communicate complex concepts, build trust, educate, and lead teams
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Benefits
- CalPERS retirement
- 457(b) option with a contribution match
- Generous paid time off including vacation, holidays, sick leave
- State of the art fitness center on-site
- Medical Insurance with Dental and Vision
- Paid life insurance for employees with additional options
- Short-term and long-term disability options
- Pet care insurance
- Flexible Spending Account – Health Care/Childcare
- Wellness programs promoting work-life balance
- Career advancement opportunities and professional development
- Competitive salary with annual merit increase
- Team bonus opportunities