Chief Medical Director/ MD/DO|
Compensation: $240K - $340K / Year
Minimum Education: Doctorate
Job Type: Full Time
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Direct and coordinate the medical management, quality improvement and credentialing functions for the assigned business unit based on, and in support of the strategic plan, establishing the strategic vision and attendant policies and procedures.
Serves as clinical advisor to and educator of medical management staff making sure correct clinical judgment is applied to all medical management determinations.
Oversees internal medical review guidelines to ensure clinical integrity and compliance and acts as a resource for staff members throughout the operation.
Coordinates with other departments, the responses needed to address regulatory accreditation concerns pertaining to medical management issues
Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services.
Facilitates the achievement of the Medical Management Program goals through an effective health services delivery system.
Responsible for physician review and oversight of all potential adverse determinations including pre-certifications/prior authorizations, concurrent review and appeals/retrospective review.
Responsible for HEDIS improvement and strategy.
Actively participates in the auditing process of medical management processes and corrective action team projects for medical management
Achieves utilization, cost management and quality goals.
Participates and advises in the development of corporate medical policies for UM, pharmacy, and new technology
For Home State Health Plan only – responsible for the sufficiency and supervision of the health plan provider network
Qualifications & Education/Experience:
- Medical Doctor or Doctor of Osteopathy, board certified in a specialty recognized by the American Board of Medical Specialists. - Volunteer patient care required. Previous experience as Medical Director is preferred. Master’s degree in Business Administration, Public Health, Healthcare Administration or related field preferred.
Board Certification through American Board of Medical Specialists. Current state medical license without restrictions.
Additional Job Information To Note When Applying:
Is Relocation Available?
Is there additional variable compensation?
30% targeted annual bonus stock
Are you open to sponsorship?
This position has:
1 position open
Is there a possibility to work remote?
Is there equity?
Are there flexible work hours?
Does this position have direct reports?
When applying ,please answer the following questions:
Candidate Pre-Screen Questions
* Do require sponsorship of any kind?
* Are you seeking a remote position?
* Please include your salary expectations, current location of and availability to start a new position.
0 of 2000 char
* If necessary, Are you willing to relocate?
* Do you possess an IN state license?
* Are you an actively practicing physician?
* How many years of experience do you have as a supervisor or manager including hiring, training, assigning work and managing the performance of staff?
WorkStaff USA Staffing Agency, LLC
P.O Box 177
Farmingville, NY 11738