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Senior Medical Director - Utilization Review - Miami, Florida
Job Summary
Occupation
Physician
Specialty
Administrative/CEO
Salary
$275,000
– $300,000
• yearly
Degree Required
MD/DO
Position Type
Permanent/Full-Time
Work Environment
Corporate/Non-Clinical
Location
Miami, Florida, United States
Visa Sponsorship
No
Job Description
Last Update:
10/17/19
We are currently searching for a board certified physician to become The Senior Medical Director with experience medical management of medicare and / or medicaid Products. The medical director will be responsible for the leadership of medical management activities. This encompasses primary responsibility for both operational and clinical excellence across utilization and case management in a unique, at-risk, home-based services model. As such, the role includes the design and implementation of medical and quality programs/policies, constant evaluation of opportunities for improvement, coordination/collaboration with other providers, and a strong understanding of how to leverage data and clinical know-how in a fast-paced care delivery setting. You will be part of the leadership team setting the strategic direction and goals for medical management. The director will also partially responsible for maintaining and cultivating relationships with local providers and health plan medical directors. Finally, the director will support the executive team and clinical staff in strategic planning, compliance, UM, care management and process improvement to deliver efficient high quality, affordable care to all in the home and post-acute settings. This executive position will require a minimum of 5 years in clinical practice of adult and / or Geriatric patients.
For more information and to schedule an interview please send your CV via e-mail.ADV/9-19
- Relevant specialty training a plus
- Experience with home-based services, SNF, or broader post-acute a plus
- Experience with plan quality/HEDIS/related a plus
- Minimum 3 years Health Plan UM, QI and Provider Relations Experience or equivalent Medical Management in a similar setting
- Previous experience in Peer to Peer, Utilization Review, Evidence Based Practice, Population Health and Chronic Care Program Management preferred
- Diplomatic and Collaborative Interpersonal, Communication, Listening and Presentation skills.
For more information and to schedule an interview please send your CV via e-mail.ADV/9-19