Description

Morgan Consulting Resources, Inc. has been retained to lead the search for a Director, Medical Management for TECQ Partners. This position is fully remote with an opportunity for quarterly travel to Houston, TX.

About the Company:

TECQ Partners operates as a value-based care organization supporting Medicare Advantage populations through direct contractual relationships with national and large enterprise health plans. The organization focuses on full-risk care models that align clinical outcomes, provider performance, and financial accountability. Its operating approach is designed to support coordinated care delivery while creating alignment between member needs and provider incentives.

Through its administrative and clinical platform, TECQ Partners enables provider groups to dedicate greater time and attention to patients with complex medical needs. Providers work within a single, integrated framework rather than managing multiple payer relationships, and participate in structured quality and performance programs tied to outcomes and cost management.

TECQ Partners provides an end-to-end set of operational and clinical support services in compliance with Centers for Medicare & Medicaid Services (CMS) regulations and National Committee for Quality Assurance (NCQA) standards. These services include utilization management and case management activities, claims adjudication and payment operations, provider credentialing, regulatory and compliance support, financial and revenue cycle services, network oversight, population health management, quality and HEDIS performance improvement, and value-based care program execution.

Learn more at tecqpartners.com.

About the Position:

The Director of Medical Management provides operational oversight and performance leadership for Intake, Prior Authorization, Utilization Review, and related medical management correspondence, ensuring compliance with all regulatory, contractual, and accreditation requirements. The role also oversees Care and Case Management functions and is responsible for the strategic planning, scalability, and ongoing growth of the Medical Management department to support the current and future needs of TECQ Partners.

In this capacity, the Director of Medical Management serves as the primary liaison to contracted vendors and health plans for medical management related activities, including delegation oversight and audit coordination, particularly for plans that delegate credentialing and other medical management functions to TECQ Partners.

The Director of Medical Management works collaboratively across the organization and demonstrates the ability to foster strong communication and teamwork among physicians, medical management staff, corporate departments, external vendors, and senior leadership to support effective, compliant, and high-quality medical management operations.

This position, along with team members within assigned units and across the organization, fosters an engaging and professional environment committed to respect, inclusivity, continuous improvement, and teamwork.

Key Responsibilities:

• Quality Programs & Performance Improvement
• Utilization & Appeals Oversight
• Delegation Oversight & Health Plan Relations
• Policies, Procedures & Regulatory and Accreditation Compliance
• Operational & Workforce Management
• Leadership, Budgeting & Strategic Planning
• Professional Judgment & Development

Required Experience:

• 5+ years in a leadership position in care management in a health plan or medical group setting
• 5+ years of experience supervising clinical staff
• 2+ years of Medicare Advantage experience
• Experience working in a health plan or an integrated health model
• Current experience with CMS regulations and NCQA standards survey protocols
• Experience with process development and program implementation
• Comfortable working with partnered clinical health plans to support regulatory compliance and quality improvement programs

Required Qualifications:

• Active and unrestricted Texas RN licensure; if not currently licensed in TX, must have a current RN license and obtain TX RN within six months of hire date
• Bachelor’s degree required; master’s preferred
• Current knowledge of Texas State and CMS regulations; knowledge of NCQA standards