Job Overview
Location
33 Locations
Job Type
Full-time
Category
Software Engineering
Date Posted
July 9, 2026
Full Job Description
📋 Description
- • Join Martin's Point Health Care, an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond.
- • As a joined force of 'people caring for people,' Martin's Point employees are on a mission to transform our health care system while creating a healthier community.
- • Martin's Point employees enjoy an organizational culture of trust and respect, where our values - taking care of ourselves and others, continuous learning, helping each other, and having fun - are brought to life every day.
- • The Vice President, Medical Director, Health Plan provides senior clinical leadership across the Health Plan, with a focus on quality, affordability, compliance, clinical performance, and member outcomes.
- • This role requires strong health plan experience, the ability to lead across functions, and the communication skills to influence clinical, operational, financial, regulatory, and executive stakeholders.
- • Key responsibilities include:
- • Partner with Health Plan senior leadership to advance clinical outcomes, affordability goals, growth targets, and overall health plan strategy.
- • Provide clinical leadership across utilization management, care management, population health, quality, pharmacy, medical policy, payment policy, and clinical program development.
- • Lead cross-functional collaboration among Medical Directors, Medical Economics, Quality, Network, Compliance, Pharmacy, Operations, and Clinical Programs.
- • Support compliance with government program requirements, including clinical appeals and grievances, using sound clinical evidence and medical judgment.
- • Use clinical, quality, utilization, and financial data to identify trends, assess performance, and recommend actionable interventions.
- • Develop strategies to improve medical expense management, appropriate utilization, quality of care, and population health outcomes.
- • Provide clinical input into product design, Medicare bids, risk adjustment, STARS, HEDIS, value-based arrangements, and clinical integration initiatives.
- • Communicate complex clinical, regulatory, and operational information clearly to executive, provider, clinical, and non-clinical audiences.
- • Support appropriate utilization of services through strong partnership with Utilization Management, Care Management, and physician leaders.
- • Represent the organization with regulatory entities, professional societies, providers, network partners, and external stakeholders, as appropriate.
- • Build and strengthen relationships with hospitals, physicians, and other health care providers to support network engagement and performance goals.
- • Support strategies tied to population health, care management, provider performance, and contractual outcomes.
- • Lead, support, and develop physician leaders and clinical team members, as assigned.
🎯 Requirements
- • Medical Degree, MD or DO, from an accredited medical school.
- • Board certification in a relevant medical discipline or specialty.
- • Active, unrestricted medical license, or ability to obtain licensure in a state relevant to the role.
- • Ten or more years of professional experience, including clinical practice experience.
- • Health plan, managed care, or payer experience in a Medical Director or comparable physician leadership role.
- • Demonstrated experience working across health plan functions, such as utilization management, care management, quality, appeals and grievances, population health, medical economics, provider relations, pharmacy, compliance, or network.
- • Experience using clinical, quality, utilization, or financial data to guide decisions, develop interventions, and measure outcomes.
- • Strong cross-functional leadership skills, with the ability to align clinical, operational, financial, and regulatory priorities.
- • Strong verbal, written, and presentation skills, including the ability to communicate effectively with executive, clinical, provider, operational, and regulatory audiences.
- • Ability to influence, collaborate, and build credibility with internal and external stakeholders.
- • Strong analytical, problem-solving, and decision-making skills.
- • Demonstrated alignment with Martin’s Point Health Care values.
🏖️ Benefits
- • 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.
Skills & Technologies
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About Martin
Martin is a leading provider of highly engineered, mission-critical products and services for the aerospace, defense, and industrial sectors. The company specializes in complex engineering solutions, including advanced manufacturing, repair, and overhaul services. Martin's expertise spans a wide range of applications, from commercial aircraft components and defense systems to industrial gas turbines and specialized equipment. With a commitment to innovation, quality, and reliability, Martin partners with its customers to deliver customized solutions that enhance performance, extend product life, and ensure operational integrity. Their focus on cutting-edge technology and stringent quality control makes them a trusted partner for demanding industries worldwide.
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