Family Practice - Without OB Physician

We are seeking an experienced and mission-driven Associate Medical Director specializing in Family Medicine for a locum-to-permanent opportunity. This role provides hands-on clinical leadership within a managed care environment, supporting utilization management, quality improvement, and population health initiatives for PCHP members.The position is fully remote during the locum assignment and will transition to a hybrid work model upon permanent hire.Key Responsibilities:Clinical Oversight & Utilization ManagementReview prior authorization and appeals requests to determine medical necessity and claims payment decisionsConduct peer-to-peer reviews to support utilization management decisionsProvide clinical oversight for utilization management, disease management, and quality management programsAssist in development and implementation of medical policies, clinical standards, and evidence-based guidelinesProvider & Network OversightAnalyze provider performance data and establish provider profilesParticipate in credentialing reviews, site visits, and medical record auditsSupport corrective action and review processes for providers not meeting standardsPharmacy & Fraud OversightCollaborate with the Pharmacy Director to oversee pharmacy benefits and coordinate medical and pharmacy careAssist in oversight of fraud, waste, and abuse (FWA) clinical programsLeadership & Strategic SupportParticipate in annual goal setting, quality initiatives, and departmental planningSupport budget development and monitoring for assigned clinical areasIdentify opportunities for process improvement, workflow optimization, and operational efficiencyServe on managed care, clinical, and interdisciplinary committees as assignedEducation & External RepresentationIdentify provider and member education needs and support health promotion initiativesRepresent PCHP in clinical matters with state and local agencies (e.g., Texas HHSC, Texas Department of Insurance, Texas Medical Association)Stay current with regulatory requirements, managed care trends, and best practicesRequirements:Board Certification in Family Medicine (no exceptions)Active Texas Medical License or willingness to obtainExperience in managed care and prior authorizationFamiliarity with Texas Medicaid RegulationsAbility to oversee and collaborate with a multidisciplinary care team