responsible for serving as the Operational Medical Director for our care management models for our National Account clients
responsible for supporting the clinical vision and implementation to deliver an improvement in the health of the people we serve
supports product strategy/design through medical management that impact health care quality, cost, and outcomes
improving access to the health improvement tools offered to clients/members
provides clinical expertise in all aspects of utilization review and case management
provides input on the clinical relevance to account reporting regarding use of medical services by members
involved in identifying and managing medical utilization trends, emerging trends and market changes that impact the client and members
proactively identifying and solutioning with account management, Sales RVP Medical Directors

Requires MD or DO and Board certification approved by one of the following certifying boards is required, where applicable to duties being performed, American Board of Medical Specialties (ABMS) or American Osteopathic Association (AOA)
Must possess an active unrestricted medical license to practice medicine or a health profession
Minimum of 10 years of clinical experience; or any combination of education and experience, which would provide an equivalent background
For Health Solutions and Carelon organizations (including behavioral health) only, minimum of 5 years of experience providing health care is required
Indiana MD license or compact state multi-licensure is preferred but not exclusive
Board certification preferably in a Primary Health Specialty, Family or Internal medicine or Surgery (surgical specialty)
Knowledge and experience with population or segment health management is a plus
Knowledge of the health insurance industry and the National Accounts segment is preferred

National Accounts Medical Director

Key skills