ApplyBlast uses AI to match you with the right jobs, tailor your resume and cover letter, and apply automatically so you can land your dream job faster.

Features

Auto Apply Resume Optimizer Cover Letter Optimizer Interview Prep

Company

Social Media

Need Help?

team@applyblast.com

Lead Medical Director, Utilization Management at Clover Health - ApplyBlast

Lead Medical Director, Utilization Management

Clover Health

1 day ago

3.7 on Glassdoor

Remote

Full Time

Director

0 applicants

View Job Listing

Apply to 100+ jobs

About this role

The Lead Medical Director, Utilization Management at Clover Health oversees the evaluation of outpatient referrals and inpatient direct admissions to ensure medical appropriateness and evidence-based care. This role involves managing a team of medical directors, developing clinical policies, and chairing the Utilization Management Committee to drive quality and access improvements. The position requires strong clinical judgment, leadership experience, and expertise in utilization management and regulatory requirements.

Responsibilities

Evaluate outpatient referrals and inpatient admissions for medical appropriateness
Manage a team of Utilization Management Medical Directors
Develop and maintain clinical policies and medical necessity criteria

Skills

Qualifications

MDDOactive, unrestricted medical licenseboard certified in a relevant clinical specialty

About Clover Health

cloverhealth.com

Headquarters

Nashville, Tennessee, United States

Company Size

501-1000 employees

Founded

2014

View Profile

Clover Health is a Medicare Advantage provider offering HMO and PPO plans—many with $0 monthly premiums—bundling expanded benefits like dental, vision, and hearing. Headquartered in Jersey City, NJ, the company serves Medicare beneficiaries across multiple U.S. markets. Clover emphasizes a technology- and data-driven approach to care management, aiming to support providers, coordinate primary care, and improve member outcomes. It positions itself as a member-focused alternative designed to lower costs and simplify access to preventive and routine services.