Medical Director Visa Sponsorship Jobs in California
California is one of the most active states for medical director visa sponsorship, driven by its concentration of large health systems, biotech and pharmaceutical companies, and academic medical centers. Kaiser Permanente, UCLA Health, Stanford Health Care, and UCSF regularly hire medical directors and have established international sponsorship programs. Major hiring hubs include Los Angeles, San Francisco, San Diego, and Sacramento.
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Get Access To All JobsJOB SUMMARY
Provides medical oversight and expertise in appropriateness and medical necessity of services provided to members, targeting improvements in efficiency and satisfaction for both members and providers and ensuring members receive the most appropriate care in the most effective setting. Contributes to overarching strategy to provide quality and cost-effective member care.
ESSENTIAL JOB DUTIES
- Determines appropriateness and medical necessity of health care services provided to plan members.
- Supports plan utilization management program and accompanying action plan(s), which includes strategies to ensure high-quality member care - ensuring members receive the most appropriate care at the most effective setting.
- Evaluates effectiveness of utilization management (UM) practices - actively monitoring for over and under-utilization.
- Educates and interacts with network, group providers and medical managers regarding utilization practices, guideline usage, pharmacy utilization and effective resource management.
- Assumes leadership relative to knowledge, implementation, training, and supervision of the use of the criteria for medical necessity.
- Participates in and maintains the integrity of the appeals process, both internally and externally.
- Responsible for investigation of adverse incidents and quality of care concerns.
- Participates in preparation for national committee for quality assurance (NCQA) and utilization review accreditation commission (URAC) certifications.
- Provides leadership and consultation for NCQA standards/guidelines for the plan including compliant clinical quality improvement activity (QIA) in collaboration with clinical leadership and quality improvement teams.
- Facilitates conformance to Medicare, Medicaid, NCQA and other regulatory requirements.
- Reviews quality referred issues, focused reviews and recommends corrective actions.
- Conducts retrospective reviews of claims and appeals and resolves grievances related to medical quality of care.
- Attends or chairs committees as required such as credentialing, Pharmacy and Therapeutics (P&T) and other committees as directed by the chief medical officer.
- Evaluates authorization requests in timely support of nurse reviewers, reviews cases requiring concurrent review and manages the denial process.
- Monitors appropriate care and services through continuum among hospitals, skilled nursing facilities and home care to ensure quality, cost-efficiency, and continuity of care.
- Ensures that medical decisions are rendered by qualified medical personnel and not influenced by fiscal or administrative management considerations, and that care provided meets the standards for acceptable medical care.
- Ensures medical protocols and rules of conduct for plan medical personnel are followed.
- Develops and implements plan medical policies.
- Provides implementation support for quality improvement activities.
- Stabilizes, improves and educates primary care physicians and specialty networks; monitors practitioner practice patterns and recommends corrective actions as needed.
- Fosters clinical practice guideline implementation and evidence-based medical practices.
- Utilizes information technology and data analytics to produce tools to report, monitor and improve utilization management.
- Actively participates in regulatory, professional and community activities.
REQUIRED QUALIFICATIONS
- At least 3 years health care experience, including at least 2 years of medical practice experience, or equivalent combination of relevant education and experience.
- Active and unrestricted Doctor of Medicine (MD) or Doctor of Osteopathy (DO) license in state of practice.
- Board certification.
- Working knowledge of applicable national, state, and local laws and regulatory requirements affecting medical and clinical staff.
- Ability to work cross-collaboratively within a highly matrixed organization.
- Strong organizational and time-management skills.
- Ability to multi-task and meet deadlines.
- Attention to detail.
- Critical-thinking and active listening skills.
- Decision-making and problem-solving skills.
- Strong verbal and written communication skills.
- Microsoft Office suite/applicable software program(s) proficiency, and ability to learn new programs.
PREFERRED QUALIFICATIONS
- Experience with utilization/quality program management.
- Managed care experience.
- Peer review experience.
- Certified Professional in Healthcare Management (CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of America (CMSA) or other health care or management certification.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
PAY RANGE
- Pay Range: $186,201.39 - $363,093 / ANNUAL
Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
JOB SUMMARY
Provides medical oversight and expertise in appropriateness and medical necessity of services provided to members, targeting improvements in efficiency and satisfaction for both members and providers and ensuring members receive the most appropriate care in the most effective setting. Contributes to overarching strategy to provide quality and cost-effective member care.
ESSENTIAL JOB DUTIES
- Determines appropriateness and medical necessity of health care services provided to plan members.
- Supports plan utilization management program and accompanying action plan(s), which includes strategies to ensure high-quality member care - ensuring members receive the most appropriate care at the most effective setting.
- Evaluates effectiveness of utilization management (UM) practices - actively monitoring for over and under-utilization.
- Educates and interacts with network, group providers and medical managers regarding utilization practices, guideline usage, pharmacy utilization and effective resource management.
- Assumes leadership relative to knowledge, implementation, training, and supervision of the use of the criteria for medical necessity.
- Participates in and maintains the integrity of the appeals process, both internally and externally.
- Responsible for investigation of adverse incidents and quality of care concerns.
- Participates in preparation for national committee for quality assurance (NCQA) and utilization review accreditation commission (URAC) certifications.
- Provides leadership and consultation for NCQA standards/guidelines for the plan including compliant clinical quality improvement activity (QIA) in collaboration with clinical leadership and quality improvement teams.
- Facilitates conformance to Medicare, Medicaid, NCQA and other regulatory requirements.
- Reviews quality referred issues, focused reviews and recommends corrective actions.
- Conducts retrospective reviews of claims and appeals and resolves grievances related to medical quality of care.
- Attends or chairs committees as required such as credentialing, Pharmacy and Therapeutics (P&T) and other committees as directed by the chief medical officer.
- Evaluates authorization requests in timely support of nurse reviewers, reviews cases requiring concurrent review and manages the denial process.
- Monitors appropriate care and services through continuum among hospitals, skilled nursing facilities and home care to ensure quality, cost-efficiency, and continuity of care.
- Ensures that medical decisions are rendered by qualified medical personnel and not influenced by fiscal or administrative management considerations, and that care provided meets the standards for acceptable medical care.
- Ensures medical protocols and rules of conduct for plan medical personnel are followed.
- Develops and implements plan medical policies.
- Provides implementation support for quality improvement activities.
- Stabilizes, improves and educates primary care physicians and specialty networks; monitors practitioner practice patterns and recommends corrective actions as needed.
- Fosters clinical practice guideline implementation and evidence-based medical practices.
- Utilizes information technology and data analytics to produce tools to report, monitor and improve utilization management.
- Actively participates in regulatory, professional and community activities.
REQUIRED QUALIFICATIONS
- At least 3 years health care experience, including at least 2 years of medical practice experience, or equivalent combination of relevant education and experience.
- Active and unrestricted Doctor of Medicine (MD) or Doctor of Osteopathy (DO) license in state of practice.
- Board certification.
- Working knowledge of applicable national, state, and local laws and regulatory requirements affecting medical and clinical staff.
- Ability to work cross-collaboratively within a highly matrixed organization.
- Strong organizational and time-management skills.
- Ability to multi-task and meet deadlines.
- Attention to detail.
- Critical-thinking and active listening skills.
- Decision-making and problem-solving skills.
- Strong verbal and written communication skills.
- Microsoft Office suite/applicable software program(s) proficiency, and ability to learn new programs.
PREFERRED QUALIFICATIONS
- Experience with utilization/quality program management.
- Managed care experience.
- Peer review experience.
- Certified Professional in Healthcare Management (CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of America (CMSA) or other health care or management certification.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
PAY RANGE
- Pay Range: $186,201.39 - $363,093 / ANNUAL
Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Medical Director Job Roles in California
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Search Medical Director Jobs in CaliforniaMedical Director Jobs in California: Frequently Asked Questions
Which companies sponsor visas for medical directors in California?
California's largest health systems and life sciences employers are among the most active sponsors for medical director roles. Kaiser Permanente, Sutter Health, Dignity Health, Stanford Health Care, and UCSF Health have histories of sponsoring international physicians in leadership positions. Biotech and pharmaceutical companies concentrated in the San Francisco Bay Area and San Diego, including companies like Genentech and Illumina, also sponsor medical directors in clinical and scientific leadership capacities.
Which visa types are most common for medical director roles in California?
The H-1B visa is the most common visa for medical directors in California, as the role typically qualifies as a specialty occupation requiring an advanced medical degree. Physicians who completed residency or fellowship training in the U.S. on a J-1 visa may need to satisfy a two-year home residency requirement or obtain a waiver before transitioning to H-1B status. The O-1A is another pathway for medical directors with documented national or international recognition in their specialty.
Which cities in California have the most medical director sponsorship jobs?
Los Angeles and the San Francisco Bay Area account for the largest share of medical director sponsorship activity in California. Los Angeles is home to major health systems including Cedars-Sinai, UCLA Health, and Keck Medicine of USC. The Bay Area concentrates academic medical centers such as UCSF and Stanford alongside a dense biotech corridor. San Diego is a growing hub, particularly for medical directors in pharmaceutical and genomics companies, while Sacramento hosts several large regional health systems.
How to find medical director visa sponsorship jobs in California?
Migrate Mate filters job listings specifically by visa sponsorship availability, making it easier to identify medical director roles in California where employers have indicated willingness to sponsor. Rather than sorting through general job boards, Migrate Mate surfaces positions from health systems, academic medical centers, and life sciences companies across the state that are actively seeking internationally qualified candidates for medical director positions.
Are there state-specific considerations for medical directors seeking visa sponsorship in California?
California requires medical directors who hold an active clinical role to maintain a California Medical Board license, which is a separate process from federal visa sponsorship and can take several months. Employers filing H-1B petitions must meet Department of Labor prevailing wage requirements, which in California's major metropolitan areas are among the highest in the country due to high cost-of-living designations. Academic medical centers affiliated with the University of California system are cap-exempt employers, meaning they can file H-1B petitions outside the annual lottery.
What is the prevailing wage for sponsored medical director jobs in California?
U.S. employers sponsoring a visa must pay at least the prevailing wage, which is what workers in the same role, area, and experience level typically earn. The Department of Labor sets this rate to make sure companies aren't hiring foreign workers simply because they'd accept lower pay than a U.S. worker. It varies by job title, location, and experience. You can look up current prevailing wage rates for any occupation and location using the OFLC Wage Search page.