Are you passionate about evidence-based medicine and improving care for Medicare Advantage members? UCLA Health Medicare Advantage Plan is looking for a dedicated and forward-thinking Associate Medical Director to help shape the future of our plan. 

In this key leadership role, you’ll work closely with the UHMAP Medical Director and play a vital part in developing and guiding clinical policy that’s grounded in the latest scientific research and Medicare guidelines. Your work will directly support our Health Services Department in delivering high-quality, appropriate, and patient-centered care.

What you’ll do:

• Lead the development, implementation, and training of medical policies.
• Provide clinical determinations for UM (prior authorizations, concurrent reviews, appeals, grievances, peer-to-peer).
• Support day-to-day UM and Clinical Appeals operations.
• Partner with clinical and operational leaders to ensure high-quality, cost-effective care.
• Collaborate with the Pharmacy team on safe, effective medication use; participate in drug review rounds and P&T Committee.
• Contribute to interdisciplinary care team rounds for complex case management.
• Serve as clinical SME for network/provider relations and present at provider education sessions.