Administration of physical and/or behavioral health medical services
Ensure appropriate and most cost effective medical care is received
Develop and implement programs to improve quality, cost, and outcomes
Provide clinical consultation and serve as clinical/strategic advisor to enhance clinical operations
Identify cost of care opportunities
Serve as a resource to staff including Medical Director Associates
Responsible for an entire clinical program
Supports clinicians to ensure timely and consistent responses to members and providers
Provides guidance for clinical operational aspects of a program
Serves as a resource and consultant to other areas of the company
May be required to represent the company to external entities and/or serve on internal and/or external committees
Interprets medical policies and clinical guidelines

Requires MD/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
Strong oral, written, and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills
MAC experience is preferred
Medicare Fee For Service experience is preferred
OBGYN, Primary care or Internal Medicine

Medical Director

Key skills