Regional Medical Director, Utilization Management - FM/IM/Geri - Florida

One hundred clinics. One hundred thousand patients. And a utilization function about to be built from the first line. You would be the physician who builds it. This is the first Regional Medical Director for Utilization Management in the company's history. You author the policy set, the medical necessity criteria, the referral review workflow, and the founding baselines. You report to the Chief Medical Officer and work in a true dyad with an operational partner. They advise and steer. You decide. WHAT YOU WILL DO Own referral management, prior authorization criteria, and medical necessity governance across every clinic in the state Build the tiered specialist and hospital network, and manage skilled nursing placement and length of stay Run panel risk stratification and care gap closure with the care management team Drive quality, star ratings, and risk adjustment accuracy across the markets Design referral review with information technology, including where artificial intelligence genuinely helps Set the founding baselines: avoidable emergency utilization, preventable admissions, readmissions, specialist utilization, and total cost of care by clinic Protect against underuse as rigorously as overuse WHAT YOU WILL BRING MD or DO, board certified in Family Medicine, Internal Medicine, or Geriatrics, active Florida license or license eligible Current dedicated leadership of utilization management or population health inside a value based, Medicare Advantage, or risk bearing delivery organization Daily working command of medical necessity criteria, MCG or InterQual Five or more years of clinical practice in primary care Relationship instinct. The Chief Medical Officer named it as the one thing that matters most here WHY YOU WILL WANT THIS Startup speed, health system scale. A blank page, plus one hundred clinics and a patient population already through the door. Live anywhere in Florida. Pick your city and keep it. No panel required, and room to see patients if you want to stay current. Capital behind it. TPG is among the largest private equity firms in the world, with a deep healthcare portfolio. Compensation built to lead the market for this role , plus a signing bonus, relocation support, and full benefits. Fifteen minutes and you will know whether this is your seat. I will tell you exactly who the organization is and walk you through the full package. #J-18808-Ljbffr StaffMed Health Partners