• REMOTE - Director Clinical Programs, Health Plan

    Martin's Point Health Care (Portland, ME)


    Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to transform our health care system while creating a healthier community. Martin's Point employees enjoy an organizational culture of trust and respect, where our values - taking care of ourselves and others, continuous learning, helping each other, and having fun - are brought to life every day. Join us and find out for yourself why Martin's Point has been certified as a "Great Place to Work" since 2015.

    Position Summary

    At Martin’s Point Health Care, we believe better health comes from better care. We’re looking for a collaborative leader to shape the future of our Utilization and Care Management programs, serving our Medicare Advantage and TRICARE members.

    Job Description

    In this role, you’ll:

    + Lead strategy, design, and execution of innovative clinical programs.

    + Oversee utilization review operations and ensure care aligns with evidence-based guidelines.

    + Drive performance, quality, and outcomes that meet the Triple Aim—better care, better health, and lower cost.

    + Partner across departments and with external vendors to improve population health outcomes.

    + Mentor and develop a high-performing clinical team.

    What you bring:

    + RN, NP, PA, PharmD, or similar clinical licensure.

    + 5+ years’ experience in managed care, utilization/care management, and program development.

    + Strong project management and data-driven decision-making skills.

    + Knowledge of Medicare Advantage required; TRICARE experience a plus.

     

    This is a chance to make a real impact—improving care for seniors, military families, and the communities we serve.

     

    This is a remote role that will require occasional travel to Portland, Maine.

     

    This position is not eligible for immigration sponsorship.

     

    We are an equal opportunity/affirmative action employer.

     

    Do you have a question about careers at Martin’s Point Health Care? Contact us at: [email protected]