Medical Director Physician
Not Specified, TX, USA
- Healthcare
- Full-time
- Associate Medical Director
- OB/GYN
- managed care
The Associate Medical Director with OB/GYN specialization will lead clinical operations, utilization management, and provider performance in a managed care setting, focusing on affordable care for underserved populations. Responsibilities include oversight of medical necessity reviews, policy development, provider credentialing, and coordination of pharmacy and behavioral health services. The role requires board certification, strong leadership and communication skills, and experience with Texas Medicaid regulations and population-based care models.
Seeking an experienced Associate Medical Director with OB/GYN specialization to support high-quality, affordable care for underserved populations in Dallas, Texas. This physician leader will provide hands-on oversight of clinical operations, utilization management, and provider performance within a mission-driven managed care environment. The ideal candidate thrives in a collaborative, community-focused setting and is committed to advancing evidence-based, value-driven care.
Dates / ScheduleFull-time leadership role
Not open to locum, 1099, or visa candidates
Must hold active board certification (no lapsed certifications)
Review prior authorization and appeals requests; determine medical necessity.
Conduct peer-to-peer provider calls to support utilization management.
Provide clinical oversight for utilization, disease, and quality management programs.
Participate in developing medical policies, clinical guidelines, and authorization standards.
Analyze provider performance data and participate in credentialing, site reviews, and corrective actions.
Assist with oversight of pharmacy benefits and alignment between medical and pharmacy services.
Support fraud, waste, and abuse program activities.
Contribute to the development, implementation, and monitoring of annual organizational goals.
Identify and support education needs for members and providers; assist in program development.
Represent PCHP in clinical matters with state and local regulatory bodies (TDI, HHSC, TMA).
Lead or participate in managed care, interdisciplinary, and community committees.
Analyze workflows, processes, and job design; implement improvements for efficiency and effectiveness.
Maintain current knowledge of regulations, guidelines, and industry trends; integrate updates into practice.
Develop and monitor departmental budgets; ensure compliance with internal controls.
Oversee team operations including hiring, training, scheduling, supervision, and performance management.
Board Certification in OB/GYN (or relevant specialty) required; no exceptions
Texas medical license (or willingness to obtain) required
Clean malpractice and license history highly preferred
Experience in managed care, prior authorization, and population-based care models required
Familiarity with Texas Medicaid regulations required
Participation in UM committees preferred
Strong leadership, organizational, administrative, and supervisory abilities
Excellent communication, negotiation, and interpersonal skills with diverse populations
Ability to interpret clinical guidelines, treatment plans, and evidence-based care standards
Knowledge of care coordination, collaboration, population health, and social determinants of health
Understanding of pharmacy and behavioral health integration in managed care
Ability to manage confidential information and remain calm under pressure
Detail-oriented, adaptable, and comfortable applying medical expertise to operational challenges
Computer literacy and ability to manage multiple priorities effectively




