Market Medical Director

Role Overview

• drive strategy and ensure clinical excellence in clinical programs, Stars, risk adjustment and total cost of care
• strengthen partnerships with providers and health systems in the Market
• work closely with Independent Physician Associations (IPA), health systems, aligned managed service organizations (MSO) and independent practices

Requirements

• Physician (M.D. or D.O) with a current and unrestricted physician license in a state or territory of the United States
• Maintain Board Certification by a specialty board approved by the American Board of Medical Specialties, National Board of Physicians and Surgeons, or the Advisory Board of Osteopathic Specialists
• 5 years of clinical experience
• Analytical and communication skills
• Strategic thinking skills
• Proficiency in computer skills (including software applications such as Microsoft Office Product and Lotus Notes) needed for electronic documentation of case reviews
• 3 years Managed Care experience preferred but not required
• Experience with case management preferred and familiarity with fraud, waste, and abuse reviews a plus
• Strong computer skills and technical independence
• Data science background or Artificial Intelligence knowledge is a plus.

Benefits

• health and wellness benefits
• 401(k) savings plan
• pension plan
• paid time off
• paid parental leave
• disability insurance
• supplemental life insurance
• employee assistance program
• paid holidays
• tuition reimbursement
• plus other incentives