A fantastic career opportunity for a remote Health Plans Medical Director is now available with reputable healthcare organization in beautiful and serene Oregon!
The Medical Director will join a Health Plan with an integrated delivery system that is strategically and operationally aligned with the mission of Building Healthier Communities Together. As the Medical Director, you will assist leadership in developing and effectively implementing Clinical Services Division programs, especially focused on the Care Coordination department and their teams of Utilization Review and Care Management.
The primary function of the Medical Director will include utilization management, case management review, and prior authorization review. The Medical Director should have experience with health plans, Oregon Medicaid’s prioritized list, and the Medicare population in addition to familiarity with the Medicare approval process for utilization management for Medicare/Medicaid programs. The Medical Director should have the willingness to learn and openness to coaching with active Oregon MD or DO license upon hire.
The ideal Medical Director candidate should have successful completion of a residency program in a primary care specialty (Family Medicine, Internal Medicine, Pediatrics) with Board Certification preferred. Psychiatry and OB/GYN highly considered. Five (5) years of clinical practice experience required. The Medical Director should have leadership experience in a managed care system with community or migrant health centers background and the development and implementation of effective health care policy, particularly in the areas of quality monitoring, medical appropriateness, and utilization of health care services preferred.
The Medical Director will be responsible to design effective clinical practice patterns and Clinical protocols to decrease inappropriate utilization and enhance quality outcomes with current knowledge of hospital clinical quality, benchmarking, and best practices. The Medical Director will manage strategic planning, budgeting, management and goal setting with familiarity with medical staff organization, credentialing, bylaws, rules, and regulations, regulatory and accreditation standards and the issues and principles of healthcare laws and regulation.
The Health Plan is open to remote Medical Director from any of the approved states: Alabama, Alaska, Arizona, Arkansas, Connecticut, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, or Wisconsin. Current unencumbered Oregon MD or DO license required.
The Medical Director will be part of a progressive team of healthcare professionals who truly care about providing the best quality of service to the surrounding community. The Medical Director will receive excellent benefit packages with competitive salary for the location. Join now!
Health Plan Medical Director, Associate Medical Director, Chief Medical Executive, CME, Chief Medical Officer, CMO, Vice President of Medical Services, Executive Medical Director, Senior Medical Director, Jobs, Oregon
Seniority level
Not Applicable
Employment type
Full-time
Job function
Health Care Provider and Management
Industries
Human Resources Services
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