5%) Education: Doctorate Degree required Work Experience: 10+ years Clinical practice experience required and Three years of managed care experience (either in a medical group or health plan) in utilization management, population health, disease management, health care quality improvement programs, or clinical guideline development and implementation required or Three years managerial experience required Licenses: MD-Physician - State Medical Board required Knowledge, Skills and Abilities: Demonstrates an understanding of quality improvement, population health, disease management, utilization, case and disease management programs and healthcare financing and costs. The overarching goals of these activities are to fulfill regulatory requirements, improve member care and outcomes, reduce unnecessary health care expenses, and insure that clinical services are provided in a manner consistent with each health plan's b Essential Functions: Supports relevant functions of the Pharmacy and Quality Improvement & Accreditation Departments and utilization, care, and disease management processes.