Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to transform our health care system while creating a healthier community. Martin's Point employees enjoy an organizational culture of trust and respect, where our values - taking care of ourselves and others, continuous learning, helping each other, and having fun - are brought to life every day. Join us and find out for yourself why Martin's Point has been certified as a "Great Place to Work" since 2015. Position Summary At Martin’s Point Health Care, we believe better health comes from better care. We’re looking for a collaborative leader to shape the future of our Utilization and Care Management programs, serving our Medicare Advantage and TRICARE members. Job Description In this role, you’ll: + Lead strategy, design, and execution of innovative clinical programs. + Oversee utilization review operations and ensure care aligns with evidence-based guidelines. + Drive performance, quality, and outcomes that meet the Triple Aim—better care, better health, and lower cost. + Partner across departments and with external vendors to improve population health outcomes. + Mentor and develop a high-performing clinical team. What you bring: + RN, NP, PA, PharmD, or similar clinical licensure. + 5+ years’ experience in managed care, utilization/care management, and program development. + Strong project management and data-driven decision-making skills. + Knowledge of Medicare Advantage required; TRICARE experience a plus. This is a chance to make a real impact—improving care for seniors, military families, and the communities we serve. This is a remote role that will require occasional travel to Portland, Maine. This position is not eligible for immigration sponsorship. We are an equal opportunity/affirmative action employer. Do you have a question about careers at Martin’s Point Health Care? Contact us at: jobinquiries@martinspoint.org