Note: The job is a remote job and is open to candidates in USA. Included Health is a new kind of healthcare company, delivering integrated virtual care and navigation to millions of members throughout the country. The Medical Director of Clinical Affairs serves as a strategic clinical partner, bridging the company, clients, and stakeholders while leveraging data and technology to improve healthcare experiences and outcomes.
Responsibilities
- Serve as a trusted clinical thought leader for strategic enterprise clients, advising executive committees on topics such as clinical policy guardrails, healthcare AI integration, and benefits strategy
- Analyze population utilization data to develop strategies, rising-risk briefs, and clinical campaign designs that alter the cost and health trajectory of client populations
- Manage the high-stakes, high-visibility, or high-dollar case desk—providing clinical case memos, peer-to-peer discussions, and member-facing clinical framing guidance
- Review aggregate member health and claims data to uncover systemic inefficiencies and low-value care patterns, providing plan sponsors with clinical guidance on how to optimize their benefit ecosystem
- Lead multi-vendor clinical rounds bringing together Included Health, client HR leaders, third-party administrators (TPAs), carriers, and other point-solutions to align on clinical action plans
- Direct the clinical narrative around High Cost Claimants (HCC) within client populations, moving HCC efforts from static reporting to active, clinically led member support
- Partner with Sales and Client Success teams during high-stakes prospect pitches and renewal cycles to showcase the clinical and economic value of our programs, driving upsells, revenue generation, and customer retention
- Represent Included Health at national conferences, industry events, and seminars to showcase our clinical performance, navigation, and virtual care capabilities
- Develop and deliver highly engaging educational materials and clinical presentations for clients, healthcare professionals, and public stakeholders
- Partner directly with the Business Strategy team to evaluate external vendors, co-develop our clinical strategy, identify emerging market needs, and determine what clinical offerings can be delivered effectively at scale
- Leverage health plan and TPA expertise to build out consistent, structured clinical support for the health plan side of our business, assisting with ecosystem integration, strategic carrier collaborations, and the expansion of innovative models like Alternative Plan Design (APD)
Skills
- Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO) degree
- Minimum of 5 years of post-residency clinical experience
- Active medical license in good standing in state of residence
- Must maintain board certification in primary specialty throughout employment
- Willingness to travel up to twice per month for 1-2 days each (averaged over the year) for client engagements and conferences, occasionally with short notice
- Proven experience in clinical consulting through experience such as corporate/health plan Medical Director, clinical SME in the digital health field, or through work in healthcare consulting
- Deep working knowledge of Health Plans, TPAs, and commercial benefit ecosystems, with direct experience in Alternative Plan Design (APD) or health plan client support
- Experience analyzing healthcare claims, utilization reports, or clinical data to pull out population trends, track clinical quality, and identify opportunities to improve healthcare spend
- Comprehensive understanding of the digital health landscape, emerging clinical technology trends (including AI in care), and virtual care delivery models
Benefits
- Remote-first culture
- 401(k) savings plan through Fidelity
- Comprehensive medical, vision, and dental coverage through multiple medical plan options (including disability insurance)
- Paid Time Off ("PTO") and Discretionary Time Off (7DTO8)
- 12 weeks of 100% Paid Parental leave
- Family Building & Compassionate Leave: Fertility coverage, $25,000 for surrogacy/adoption, and paid leave for failed treatments, adoption or pregnancies.
- Work-From-Home reimbursement to support team collaboration home office work
Company Overview
Included Health provides a combination of virtual care, navigation, and communities-based healthcare services. It was founded in 2011, and is headquartered in San Francisco, California, USA, with a workforce of 1001-5000 employees. Its website is http://www.includedhealth.com.