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Chief Clinical Leader
2 semanas atrás
The Medical Director is a key role in our organization, responsible for leading and coordinating medical management, quality improvement, and credentialing functions. This position requires a strong clinical background, leadership skills, and ability to drive meaningful change in the community.
Key Responsibilities- Provides medical leadership of all utilization management, cost containment, and medical quality improvement activities.
- Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services.
- Supports effective implementation of performance improvement initiatives for capitated providers.
- Assists in planning and establishing goals and policies to improve quality and cost-effectiveness of care and service for members.
- Provides medical expertise in the operation of approved quality improvement and utilization management programs.
- Collaborates effectively with clinical teams, network providers, and appeals team for reviewing complex cases and medical necessity appeals.
- Medical Doctor or Doctor of Osteopathy degree.
- Board certification in a medical specialty recognized by the American Board of Medical Specialists or the American Osteopathic Association's Department of Certifying Board Services.
- Current state license as a MD or DO without restrictions, limitations, or sanctions from government programs.
We offer a comprehensive benefits package including competitive pay, health insurance, 401K, stock purchase plans, tuition reimbursement, paid time off plus holidays, and flexible work arrangements.
Other OpportunitiesThis role offers opportunities for professional growth and development, collaboration with experienced clinicians, and contributions to improving healthcare outcomes for our members.
