At Altais, we’re on a mission to improve the healthcare experience for everyone—starting with the people who deliver it. We believe physicians should spend more time with patients and less time on administrative tasks. Through smarter technology, purpose-built tools, and a team-based model of care, we help doctors do what they do best: care for people.

Altais includes a network of physician-led organizations across California, including Brown & Toland Physicians, Altais Medical Group Riverside, and Family Care Specialists. Together, we’re building a stronger, more connected healthcare system.

About the Role

Are you looking to join a fast-growing, dynamic team?

We’re a collaborative, purpose-driven group that’s passionate about transforming healthcare from the inside out. At Altais, we support one another, adapt quickly, and work with integrity as we build a better experience for physicians and their patients.

• The Medical Director plays a vital role in both the development and implementation of Utilization Management policy and procedures. This physician is chosen based upon their knowledge of medical practice, experience in Managed Care,Utilization, Quality Managementprogramsand an ability to interact well with the other physicians.  

• Works to continually enhance the overall efficiency and quality of care for patients served by One Altais through effective network management.  

• Develop andmaintaincollaborative functioning relationships with key providers, particularly thought leaders, across the One Altais service delivery footprint.  

• The Medical Director will provide cooperative leadership and direction to the UMC (Utilization Management Committee) Primary Care Physicians (PCP)and all Specialist Physicians as assigned by the Senior Medical Director.  

• The Medical Director may be asked to co-chair several committees including the Utilization Management Committee, The Quality Management Committee, the Peer Review and Patient Safety Committee, and others as needed.  

• The Medical Director maybe responsible forinterfacing withhealth plansregardingbenefits, coverage issues, response to appeals, attend HMO hearing on appeals and administrative issues which cannot be settled by the Case Managers and/or Management. 

• The Medical Director will work closely with physician leaders across all healthcare settings to ensure that patient care is managed in acost containmentmanner without compromising health outcomes. 

• This physician leader willfacilitateclinical rounds with the Case Managers & Management to ensure bed day performance goals are met. 

• Collaborate with the Senior Medical Director and Chief Office for Health and Innovation to engage network physicianswith regard toperformance, cost, clinicalappropriatenessand authorizations. 

• This individualtakesan active role in the development and promotion of managed care systems within One Altais. This will include development of UM policies and procedures,identifyingthe type of criteria to be used for authorization review, and implementation of a regular forum in which to educate PCPs and specialists onutilizationmanagement systems.  

• The Medical Director also serves asan important resourceand key contact foridentifiedcase management problems andparticipatesin IDCT (Interdisciplinary Care Team) Meetings. 

• The Medical Director supports the Senior Medical Director as a resource person for Physician Education on UM and input into the One Altais UM goals andobjectives 

• Coordination of prospective, concurrent, retrospective review including denial and/or approval of all outside medicalservices referralsas necessary. 

• Develop andmaintainwritten medical care protocols andassureUM Standardization. 

• Chart Reviews for Appropriateness of applying clinical guidelines. 

• Physician to Physician liaison for UM related issues. 

• Prepare and review Decision Validation Criteria as required by UM. 

Required Meetings:     

UM Committee   

Health Plan Joint Operations Meetings 

Hospital Joint Operations Meeting 

One Altais Meetings involving Utilization Management 

Compassion

We act with empathy and a deep respect for the challenges faced by physicians and their patients. Our work is driven by a genuinecommitment to improving lives and ensuring that care is delivered with dignity, understanding, and humanity.

Community

We foster a culture of collaboration--with physicians, patients across the healthcare ecosystem, and among our teams. By building strong,trusted relationships, we create a unified community focused on advancing patient care and physician well-being.

Leadership

We lead with integrity and vision, setting the standard for excellence in physician support and healthcare innovation. Through collaboration andexpertise, we empower others to lead, drive change, and shape the future of care.

Excellence

We are relentlessly focused, results-driven, and accountable for delivering measurable value to physicians and the patients they serve. Our highstandards reflect our commitment to excellence, operational discipline, and continuous improvement.

Agility

We embrace change as a constant and respond swiftly to the evolving needs of the healthcare industry. With flexibility and forward-thinking,we adapt, innovate, and act decisively to keep physicians at the forefront.