Job Title: Vice President of Medical Directors – Health Plan
Salary Range: $360,000–$380,000 per year
Location: New York City, NY
Hybrid: Approximately 1 day per week onsite
Employment Type: Full-Time, Direct Hire
Position Summary
RCM Healthcare Services is seeking an experienced Vice President of Medical Directors for a direct-hire leadership opportunity with a major health plan in New York City. Reporting to the Chief Medical Officer, this physician executive will provide leadership across medical management functions, with a particular focus on Utilization Management, health informatics, medical quality, regulatory compliance, and appropriate healthcare delivery.
The role combines clinical and operational oversight with data strategy, policy development, regulatory involvement, and strategic planning across multiple lines of business and pharmacy. At RCM Healthcare Services, we're passionate about connecting talented professionals with the right opportunities — join our network and be supported every step of the way.
Responsibilities
Schedule / Work Arrangement

• Full-time leadership position
• Hybrid work arrangement
• Approximately 1 day per week onsite in New York City

Key Duties

• Provide physician leadership across medical management functions, with a primary focus on Utilization Management (UM).
• Review complex cases, determine medical necessity, and consult with physicians regarding length of stay, level of care, and reimbursement documentation.
• Support UM staff and nurse Care Managers with concurrent review and preauthorization referrals, ensuring members receive appropriate services consistent with benefits, regulatory requirements, and established clinical criteria.
• Provide clinical expertise for member and provider appeals and collaborate with senior clinical leadership responsible for day-to-day UM operations.
• Help develop and advance the organization's health informatics and data capabilities, using data and reporting to support clinical and operational decision-making.
• Participate in clinical policy review, new technology assessment, and implementation of policy and procedural changes resulting from state and federal regulatory requirements.
• Contribute to strategic planning for existing and expanding health plan business.
• Represent the organization at regulatory and industry meetings, including meetings involving New York State and New York City health agencies and managed care organizations.
• Partner closely with the Chief Medical Officer and other executive leaders on medical management strategy and organizational priorities.

Requirements
Education & Experience

• Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) degree from an accredited and approved medical school.
• Minimum of 3 years of clinical experience post-residency.
• Minimum of 5 years of experience in a managed care/health plan setting.
• At least 3 years of experience specifically overseeing Utilization Management.
• Proven experience with health informatics and/or healthcare data analytics.
• Demonstrated knowledge of healthcare regulatory compliance.
• Experience with New York State regulations and compliance strongly preferred.

Licenses & Certifications

• Valid New York State medical license and current registration required.
• Board Certification required.

Skills

• Strong physician executive leadership skills with demonstrated experience in a managed care environment.
• Extensive knowledge of Utilization Management, medical necessity, clinical criteria, and regulatory requirements.
• Ability to leverage healthcare data and informatics to support clinical and operational decision-making.
• Excellent written, verbal, interpersonal, and executive-level communication skills.

About Us
RCM Healthcare Services works with professionals across schools, healthcare, and community-based settings nationwide. We support both contract and direct hire opportunities, connecting people early in their careers and experienced professionals to roles that align with their experience and preferences. With more than 50 years of staffing experience, our team understands the environments you're stepping into and what it takes to be successful in them.
We stay closely involved from first conversation through placement, with consistent communication, a reliable point of contact, and follow-through at every step. We're committed to caring for the professionals we work with and the communities they support and offer competitive pay and benefits designed to support your well-being. RCM Healthcare Services is Joint Commission certified, reflecting a commitment to quality, compliance, and a consistent experience.
Equal Employment Opportunity & Reasonable Accommodation
RCM Technologies is an equal opportunity employer and values diversity. We are committed to providing reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act (ADA) and applicable state laws. If you require a reasonable accommodation to apply for or perform this role, please contact us and we will engage in an interactive process to support your needs.