commensurate and based on prior experience
Are you an MD or DO with utilization management/review experience? If so, keep reading!
One of our clients is seeking a Medical Director for a remote opening.
- Research and analyze clinical or other data such as:
- Medical records, claims data, authorization data, and appeals data
- Read and interpret medical and clinical literature and apply to understand of research study design and quality of clinical evidence
- Review and interpret policies, accreditation standards, regulations, etc. related to medical and clinical topics
- Conduct assessments and implementations of medical policies and clinical operations within the organization and department
- Gather and review clinical and other information related to specific cases or decisions (e.g., contact and listen to providers; case managers)
- Present clinical programs and results to:
- Client, employer meetings, physicians, and healthcare providers
- Deliver group presentations on clinical programs, data, and information
- Explain and influence the development of technical and clinical communications that will be delivered to external audiences (e.g., new clinical policies, programs, processes)
- Discuss clinical program outcomes, data, and performance with providers, employers, accreditors, and regulators
- Deliver clinical and coverage decisions and information and respond to questions and concerns (e.g., from regulators, accreditors, legal/risk management, employers, healthcare providers)
- Develop, update, and review relevant clinical and other documents (e.g., clinical guidelines, operational policies, benefits documents, SOPs)
- Develop, recommend, and implement quality, affordable service initiatives
- Solicit or respond to feedback and input on clinical initiatives and guidelines (e.g., providers, specialty societies, clinical experts)
- Assess current and prospective staff's clinical knowledge and capability and the ability to apply these skills in a medical management environment
- Identify and address gaps in clinical, medical, and administrative knowledge and skills of internal team members
- Conduct self-assessment of competence in various areas of medicine and implement development strategies to build knowledge and apply evidence-based on medicine to perform in these clinical areas
- Deliver presentations to others (e.g., employer groups, providers, internal staff) on clinically - related topics
- Educate teams on clinical quality, cost, and service initiatives
MUST be a Medical Doctor or Doctor of Osteopathic Medicine
*Proof of COVID vaccination required
All qualified candidates must send an updated copy of their resume to Caroline Cristini at [ Email address blocked ] - Click here to apply to Medical Director
for immediate consideration. Upon emailing Caroline or applying to this role, be on the lookout for an email from [ Email address blocked ] - Click here to apply to Medical Director
to set up a phone screen (a phone screen is required in order to complete your application). If you do not have a phone screen set up, you will be unable to be considered by our client.
Looking forward to our conversation!
Caroline Cristini, National Healthcare Recruiter
[ Link removed ] - Click here to apply to Medical Director
- Authorization (Medical)