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Medical Director, Care & Case Management

Included Health· Clinical Strategy and Services
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Remote$240.7k - $310k + equity + bonusFull-timePosted 2mo ago

About the role

Medical Director leading the care, case, and utilization management programs ( CCM and UM ), setting clinical direction and owning program performance. Responsible for achieving clinical outcomes, client commitments, and third-party oversight within Included Health’s population health strategy.

Responsibilities

  • Serve as the clinical escalation point for care, case, and utilization management programs.
  • Set and maintain clinical standards, evidence-based care pathways, and clinical quality expectations across the portfolio, using clinical judgment in collaboration with subject matter experts.
  • Own clinical KPIs, including setting targets, evaluating performance gaps, and redesigning workflows to close them.
  • Interrogate the data. Identify outliers or workflows that don't make sense, and drive them to resolution and improvement.
  • Run the program's operating cadence, including weekly performance reviews, escalation triage, and action tracking, to the team accountable to committed targets and timelines.
  • Evolve the clinical operating model across adult, maternity, and pediatric populations to deliver on Included Health’s population health strategy.
  • Partner with Product and Engineering to design, validate, and deploy AI and agentic tools into clinical workflows, and ensure AI-generated output is valid and actionable.
  • Build new programs and models of care, and define how they scale across populations and clients.
  • Lead, manage, and develop leaders, setting clear clinical and operational expectations.
  • Conduct performance reviews, coaching, and feedback for direct reports.
  • Attract and retain a strong, diverse pool of clinicians and talent aligned with company vision and goals.
  • Partner with other clinical leaders and cross-functional stakeholders to coordinate care for members with multi-specialty needs.
  • Represent care management in cross-functional initiatives, pilots, and strategic planning related to complex care.
  • In partnership with the Quality team, implement quality assurance processes to ensure consistent, excellent service to members.

Qualifications

  • Education: Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO).
  • Board certified in internal medicine, family medicine, med-peds, or a related specialty, with a minimum of 7 years of post-residency clinical experience.
  • Minimum of 5 years in a healthcare leadership role with direct oversight of clinical teams or programs (managing managers).
  • Active, unrestricted medical license in good standing in state of residence, plus active multi-state licensure or willingness to obtain it.
  • Track record of delivering against operational KPIs (productivity, clinical quality, engagement) in a scaled, performance-driven setting.

Skills

Required:Clinical leadershipPopulation health strategyOperational leadershipData-driven decision making

Benefits

  • Remote-first culture
  • 401(k) savings plan through Fidelity
  • Comprehensive medical, vision, and dental coverage
  • Paid Time Off (PTO) and Discretionary Time Off (DTO)
  • 12 weeks of 100% Paid Parental leave
  • Fertility coverage and paid leave for surrogacy/adoption, and paid leave for failed treatments/adoptions/pregnancies
  • Work-From-Home reimbursement
Last updated Oct 21, 2026. Interested? Apply on the company site.

About Included Health

Designed to treat you better.™

Included Health delivers personalized virtual care, navigation, and cost-saving healthcare solutions for employers, health plans, and members.

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