Medical Director needed in Dallas, TX

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 / Schedule

• Full-time leadership role

• Not open to locum, 1099, or visa candidates

• Must hold active board certification (no lapsed certifications)

Job Details / Responsibilities

• 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.

Required Skills & Qualifications

• 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