Medical Director – Clinical Strategy

About This Opportunity

We are representing a confidential national health plan seeking a Medical Director to lead clinical strategy initiatives for high-risk and complex care populations. This strategic role partners across clinical, product, technology, and analytics teams to develop AI-enabled solutions and scalable programs that improve outcomes and affordability for members with serious illness, oncology needs, complex chronic conditions, and high pharmaceutical costs.

Our client is investing significantly in digital health innovation and AI-powered care management capabilities. This position will be instrumental in translating clinical priorities into actionable roadmaps, business cases, and measurable execution plans.

Responsibilities

• Develop and execute strategy for high-risk populations including oncology, serious illness, specialty pharmacy, and complex chronic conditions
• Lead design of AI-enabled solutions including AI agents, advanced member segmentation, proactive engagement tools, and technology-enabled case management workflows
• Translate clinical and business priorities into strategic roadmaps, business cases, and implementation plans with measurable performance goals
• Partner across Product, Technology, Data, Clinical Operations, Pharmacy, Analytics, and Finance to identify priority use cases and drive execution
• Leverage claims data, clinical trends, and operational insights to identify opportunities and prioritize initiatives
• Enhance case management models including structured case review processes and targeted interventions for complex populations
• Develop performance measurement frameworks covering clinical outcomes, affordability, member experience, and operational efficiency
• Prepare executive-level strategy documents, recommendations, and decision materials for senior leadership
• Lead cross-functional teams through complex initiatives in a matrixed environment
• Ensure digital and AI solutions are clinically sound, member-centered, operationally feasible, and financially grounded

What We're Looking For

Required:

• Active and unrestricted Medical License (MD/DO)
• Current Board Certification in an ABMS or AOA recognized specialty
• Minimum 3 years of clinical practice experience
• Experience in strategy development and implementation for healthcare organizations (payer, provider, consulting, digital health, or related sectors)
• Track record developing and executing clinical programs from concept through measurable outcomes
• Strong business or consulting background with ability to structure complex problems and translate strategy into action
• Business and financial acumen connecting clinical initiatives to affordability and value creation
• Experience using analytics and data to identify opportunities, shape strategy, and measure outcomes
• Experience leading cross-functional teams in matrixed environments
• Process improvement experience with workflows, operating models, and scalable program delivery
• Ability to influence stakeholders and drive alignment across organizations
• Executive communication skills translating complex topics into clear, leadership-ready materials
• Digital and AI fluency to partner on AI-enabled solutions, predictive analytics, and technology-enabled care management

Preferred:

• Experience in payer strategy, care management, oncology, specialty pharmacy, high-cost therapies, or clinical product design
• Background with digital health, AI-enabled clinical solutions, member engagement tools, or technology-enabled care navigation
• Experience in national health plans, clinical operations, healthcare consulting, or digital health companies
• Track record developing executive-level business cases and transformation roadmaps for clinical programs

How We Work With You

Candidates apply directly through Get A Job.ai. Our recruiting team will conduct an initial screening to understand your clinical background, strategic experience, and interest in this opportunity. Qualified candidates are then submitted to our client for consideration. Please do not contact the hiring organization directly—all communication and coordination will be managed through our talent team.

Location & Employment Details

This position is based in the United States. Remote work is supported with required internet speeds of at least 10Mbps download/5Mbps upload through cable broadband or fiber optic service.

Equal Opportunity

Get A Job.ai is committed to equal employment opportunity. We consider all qualified applicants regardless of race, color, religion, sex, national origin, age, disability, veteran status, or any other legally protected characteristic.