Showe and Associates LLC
Executive Recruiting Services for the Managed Healthcare Industry

Medical Director - Remote

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Location
Richmond, VA
Job Type
Direct Hire
Date
Jul 26, 2019
Job ID
2674736

Medical Director 

Growing integrated healthcare provider seeks a Medical Director to lead the company's utilization management clinical team in the state of Virginia.  This is a remote role, but candidates must be licensed and live in Virginia.  The Medical Director will:


  • Oversee daily utilization management activities including reviewing requests and making coverage determinations for services and supplies for delegated lines of business.
  • Act in a supporting role as medical manager and policy advisor to the company and our clients.
  • Executes the Utilization/Cost Management Programs and relevant Clinical Quality Improvement Programs in partnership with the Director, Care Management and Market Medical Directors
  • Interfaces with provider community on Utilization Management and evidence based medicine
  • Provides education to provider teammates in local markets and to the UM team regarding managed care processes as well as clinical issue

 

Requirements:
 


  • M.D. graduate of an accredited medical school, MBA or advanced degree in healthcare management preferred
  • Virginia licensure, board certified in internal medicine, family medicine, emergency medicine or primary care.
  • 2+ years experience as a physician reviewer performing peer review activities.
  • 3+ years experience in clinical practice in a primary care setting
  • Progressive medical administration experience strongly preferred
  • Proven ability in a medical leadership position in clinical credibility with  experience developing and guiding team members
  • A strong understanding of all aspects of managed care, including HMOs, PHOs, risk arrangements, capitation, peer review, performance profiling, outcome management, care coordination, pharmacy management, and patient centered medical home concepts.
  • Strong interpersonal, verbal, and written communication skills.
  • The ability to navigate in a corporate matrix environment