Job Openings

Chief Medical Director | Physician Executive

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Location
Indianapolis, IN
Job Type
Direct Hire
Date
Dec 17, 2019
Job ID
2676893

Chief Medical Director | Physician Executive|- Managed Care - Indianapolis
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You will LOVE Indy- pro sports, museums, vibrant downtown, extensive bike trails run through the city,  lakes, concert venues, eclectic collection of restaurants and nightlife.Family friendly and diverse!  Great airport and so commutable. 



Chief Medical Director will guide and mentor a team of physicians and pharmacy and serve as a key strategic leader. This is your opportunity to make a big impact on quality of care for the vulnerable populations AND to advance your career as a leader in healthcare.


 
CMD serves as clinical advisor to and educator of medical management staff making sure correct clinical judgment is applied to all medical management determinations.


Oversees internal medical review guidelines to ensure clinical integrity and compliance and acts as a resource for staff members throughout the operation.


Coordinates with other departments, the responses needed to address regulatory accreditation concerns pertaining to medical management issues


Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services.


Facilitates the achievement of the Medical Management Program goals through an effective health services delivery system.


Responsible for physician review and oversight of all potential adverse determinations including pre-certifications/prior authorizations, concurrent review and appeals/retrospective review.


Responsible for HEDIS improvement and strategy.


Actively participates in the auditing process of medical management processes and corrective action team projects for medical management


Achieves utilization, cost management and quality goals.


Participates and advises in the development of corporate medical policies for UM, pharmacy, and new technology


 


Qualifications:
-  Medical Doctor or Doctor of Osteopathy
- Board certified
- Continuing part time patient care required.
-Previous experience as Medical Director in an MCO/ACO/IPA is preferred.
-Master’s degree in Business Administration, Public Health, Healthcare Administration or related field preferred.
- Current medical license without restrictions (IN preferred but flexible)
- Managed Care Experience - Utilization Review Experience
-Quality/Risk and HEDIS knowledge
-MBA/Six Sigma Leadership are an added plus