Associate Medical Director

Cambia Health Solutions

. Participate in utilization management and provide clinical leadership and support to clinical teams .

Posted 10/9/2026full-timeUnited StatesLead💰 $207,000 - $370,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates clinical leadership and expertise in utilization management, ensuring quality and cost-effective care while navigating state and federal regulations. Proficient in data analysis and developing strategies to enhance health care interventions and provider relationships.

Highest-signal resume keywords

Licensed Physician (MD or DO)Board CertificationClinical Experience (3+ Years)Knowledge of Health Insurance IndustryStrong Communication Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Utilization ManagementMedical Necessity ReviewData AnalysisClinical Policy DevelopmentCase ManagementPerformance Metrics EvaluationProvider ContractingClinical Decision-MakingHealth Care InterventionsCredentialing Operations

Soft Skills

Strong CommunicationFacilitation SkillsRelationship BuildingIssue ResolutionCreative Strategy Development

Tools & Technologies

AI Tools and TechnologiesData Management Systems

Certifications & Qualifications

Active Medical LicenseBoard Certification

Industry Keywords

Health Care ServicesProvider Reimbursement MethodsAccountable Care ModelsState and Federal RegulationsIntegrated Delivery Systems

About the role

Key responsibilities & impact

Participate in utilization management and provide clinical leadership and support to clinical teams
Ensure members receive quality, cost-effective care and optimal outcomes
Provide clinical leadership for staff
Contribute to medical management strategies and tactics
Conduct peer clinical review for medical necessity on utilization management authorization requests
Provide clinical input on case management reviews with clinical staff
Discuss review determinations with providers during peer-to-peer conversations
Provide clinical input on medical policy reviews and development
Participate on committees developing programs affecting clinical interventions, utilization management, and case management
Analyze and use data to develop and implement health care interventions
Advise Health Care Services Leaders on performance metrics and initiative effectiveness
Identify and communicate opportunities in utilization management, provider contracting, and related areas
Coordinate between internal clinical programs and providers to improve quality and cost of care
Ensure ethical decision-making complies with contracts, regulations, and legislation
Support internal communication and training
Promote provider understanding of utilization management and quality improvement policies and standards
Provide guidance and oversight for clinical operational and clinical decision-making aspects of the program
Participate in health plan credentialing operations and provider services support

Requirements

What you’ll need

Licensed Physician with an MD or DO degree
Minimum 3 years clinical experience, or equivalent combination of education and experience
Active, unrestricted license to practice medicine in one or more states or territories of the United States
At least one active license in OR, WA, ID, or UT
Applicant must live in the four-state area (OR, WA, ID, UT)
Board Certification required
Qualification by training and experience to render clinical opinions about medical conditions, procedures, and treatments under review
Demonstrated competency working with hospitals, provider groups, or integrated delivery systems
Strong communication and facilitation skills
Ability to resolve issues and seek optimal outcomes
Ability to develop and maintain positive relationships with community and provider partners
Knowledge of the health insurance industry, state and federal regulations, provider reimbursement methods, and accountable care and payment models
General business acumen, including market dynamics, financial/budget management, data analysis, and decision-making
Strong orientation to applying data in managing health and quality
Ability to develop creative strategies, plan and execute complex projects and programs, and drive results
Ability to effectively lead and engage constructively with others
Experience with AI tools and technologies highly desired
Wired internet connection; satellite or cellular connections are not accepted
Minimum internet speed of 5 Mb upload and 10 Mb download
Access to a personal mobile device for MFA
Successful background check

Benefits

Comp & perks

Competitive salary
Bonus opportunities
Market-leading 401(k) with a significant company match
Potential discretionary 401(k) contribution based on company performance, with no vesting period
Medical, dental and vision coverage for employees and eligible family members, including mental health benefits
Annual employer contribution to a health savings account
Generous paid time off varying by role and tenure
10 company-paid holidays
Up to 12 weeks of paid parental time off, subject to eligibility
Award-winning wellness programs that reward participation
Employee Assistance Fund
Commute and parking benefits
Work from home options for most roles
Employee resource groups
Cambia-supported community outreach programs
Career growth and development opportunities