Medical Director, HIV and Special Needs Program – Hybrid
2 days a week in NYC office (inclluding half a day clinical) and 3 days a week remote
Salary Range: $260,000 – $276,000, with generous benefits, including a pension plan
Position Overview
Under the guidance of the Chief Medical Officer, the Medical Director for the Partnership in Care Department will oversee the HIV Special Needs Plan (Partnership in Care Program) and manage the care of all members living with HIV. This role involves strategic program development, clinical support, and collaboration with divisions such as Utilization Management, Quality Management, Finance, Member Services, and Enrollment.
Key Responsibilities

• Develop and implement a vision and strategic direction for the Partnership in Care Department, focusing on evidence-based strategies to end the HIV epidemic and deliver high-quality care for members with HIV.
• Provide oversight of the HIV Special Needs Plan (Partnership in Care) and ensure effective care management for members living with HIV.
• Design, implement, and annually review the HIV SNP’s comprehensive Quality Management/Quality Improvement Plan.
• Ensure compliance with Federal, State, and City regulations governing the HIV SNP and HIV services.
• Oversee all aspects of the HIV Special Needs Plan, reporting quarterly to the Board of Directors’ Quality Assurance Committee.
• Promote a multidisciplinary approach to patient care and ensure delivery models align with current professional standards and organizational values.
• Provide clinical support to review quality-of-care concerns investigated by the Quality Management Department.
• Review provider and facility utilization patterns and deliver targeted feedback and education as needed.
• Develop and manage the budget for the Partnership in Care Department, including fiscal planning and expenditure monitoring.
• Collaborate with internal departments such as Quality Management, Utilization Management, Marketing, Customer Services, and Finance.
• Represent the health plan at regulatory and trade organization meetings, including the NY State AIDS Institute SNP Quality Committees.
• Participate in the Medical Directors Team to support utilization management across all lines of business, including review of denials and appeals.
• Supervise a grant-funded outreach team working with community-based organizations to return members to care.

Minimum Qualifications

• Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) from an accredited institution.
• At least three years of clinical experience.
• At least two years of administrative experience, including staff supervision.
• Expertise in Care, Case, and Disease Management.

Licensure and Certifications

• Valid and current license to practice medicine in New York State.
• Completion of at least 10 hours of annual CME training in HIV care.
• Board Certified or Board Eligible in a Primary Care Specialty, with either an infectious disease fellowship or specialized training in HIV care.
• Qualified as an HIV Specialist per NYSDOH AIDS Institute standards.

Competitive Salary Range: $260,000 – $276,000, with generous benefits, including a pension plan.