Associate Medical Director - OB/GYN | Locum to Perm | Competitive Rate | Dallas, TX (SM)
Updated 12/04/25
75235, Dallas, Texas, United States
Physician
Obstetrics & Gynecology
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Job at a glance
Degree Required
MD/DO
Position Type
Locums/Travel
Work Environment
Hospital
Visa Sponsorship
No
Job description
Job description
The Associate Medical Director will take a hands-on approach in overseeing and supporting clinical activities, ensuring the delivery of comprehensive care to members.
This is a 13-week locum assignment with the intention of transitioning the provider into a permanent role.
Responsibilities:
This is a 13-week locum assignment with the intention of transitioning the provider into a permanent role.
Responsibilities:
- Reviews prior authorization and appeals requests for approval or denial of claims payment based on medical necessity.
- Performs peer-to-peer calls as necessary to support the utilization management process.
- Provides clinical oversight for utilization management, disease management, and quality management activities as assigned by leadership, including participation in development of medical policies and procedures for coverage, authorization, and clinical standards based on evidence-based medicine.
- Analyzes data to establish health care provider profiles and define acceptability of physician performance; conducts review of provider applications and qualifications; participates in the review process for providers who fail to meet required standards; and conducts site and medical record reviews, as appropriate, to ensure adherence to managed care policies.
- Assists leadership and the Pharmacy Director in overseeing and administering the pharmacy benefit, including coordination of care between the medical and pharmacy benefits.
- Assists leadership in oversight, evaluation, and administration of the clinical aspects of fraud, waste, and abuse programs.
- Participates in development, implementation, and monitoring of annual goals and objectives that support the mission and objectives of the organization.
- Assists in identifying member and provider needs for education and health promotion; participates in assessment, development, and evaluation of educational programs to ensure they meet managed care service needs.
- As assigned, assists in representing the organization on clinical activities with relevant state and local bodies such as regulatory and professional agencies.
- Participates in identification and analysis of process improvements in job design, work processes, and workflows, and implements appropriate changes to improve effectiveness, productivity, and efficiency in support of managed care goals.
- As assigned, serves as chairperson or member of managed care committees and participates on various community and interdisciplinary committees.
Job Responsibilities
Responsible for providing clinical oversight and reviewing services requiring prior authorization for procedures, medications, and hospital stays.
Identifies and analyzes job structure, work processes, and workflows, implementing changes to improve departmental effectiveness and productivity.
Stays current on industry developments by attending seminars/workshops, reviewing professional literature, participating in professional organizations, and maintaining certification or licensure; integrates new knowledge into work practices.
Maintains knowledge of relevant rules, regulations, policies, and laws; develops internal controls to promote compliance with accreditation, federal, state, and private health plan requirements.
Develops and monitors annual budgets to ensure adequate resources are available to achieve departmental goals and objectives.
Develops, implements, monitors, and revises annual goals and objectives that support the mission and objectives of the organization.
Selects, trains, schedules, motivates, supervises, and evaluates staff, making recommendations for disciplinary action up to termination; ensures ongoing learning opportunities for team members.
Skills or Special Abilities:
Philosophically aligned with the managed care model.
Working knowledge of managed care principles.
Strong leadership, organizational, interpersonal, and verbal communication skills, with the ability to work effectively with executive management, physician groups, community organizations, and diverse populations.
Working knowledge of Texas Medicaid regulations and their interpretation.
Effective supervisory, administrative, and management skills, including computer literacy.
Demonstrates patient-centered behaviors.
Knowledge of care coordination, population health, social determinants of health, evidence-based care, and value-based purchasing.
Familiarity with the roles of pharmacy and behavioral health in healthcare management.
Ability to create, review, and interpret treatment plans.
Ability to adapt to changing priorities.
Ability to manage confidential information.
Strong negotiation skills.
Ability to remain calm under pressure.
Ability to apply medical knowledge to business challenges to achieve strong member, business, and quality outcomes.
Detail-oriented with a hands-on approach.
Qualifications
Board Certification in OB/GYN (or relevant medical specialty)
Texas medical license (or willingness to obtain)
Clean malpractice/license history
Experience in managed care and prior authorization
Participation in a managed care UM committee
Ability to adapt to the managed care delivery model and oversee a multi-disciplinary team
Familiarity with Texas Medicaid Regulations
Working Hours
13 week assignment (locums)- Monday- Friday 8am-5pm
By applying you agree to our Terms of Service