Senior Medical Director

Location: Tempe, AZ
Date Posted: 03-08-2019
CareNational
Senior Medical Director (MD or DO) - Health Plan
Phoenix, AZ
 
Senior Medical Director Job Summary:
 
The Senior Medical Director is responsible for providing clinical expertise and business direction in support of medical management programs to promote the delivery of high quality, constituent responsive medical care. The Senior Medical Director is a critical medical and business leader and contact for external providers, plan sponsors, and regulatory agencies and participates in the strategic medical management.  They provide medical leadership to ensure excellent quality of care and service is provided to our members and clients that are efficient and cost effective.

Senior Medical Director Benefits:
 
This exciting position offers comprehensive and competitive salary, bonuses, and benefits!
This established, nationally-recognized organization is a Fortune 500 company that is committed to the health and happiness of all their staff. They offer a comprehensive benefits package to all full-time, permanent employees including low cost health insurance plan, dental, vision, and life insurance. To assist employees in living a healthier life, they offer either on-site fitness center or discounts to local fitness centers and a comprehensive wellness programs. They also offer free or reimbursed parking, tuition assistance, matching 401(k), employee stock purchase plan, generous PTO plus paid holidays, and much more!
 
Senior Medical Director Background: 
 
  • Formal education including a Doctor of Medicine (M.D.) or Doctor of Osteopathic Medicine (D.O.) degree.
  • Must hold an active unrestricted license to practice medicine in the state at hire.
  • Strongly prefer those authorized to prescribe controlled substances / valid DEA certificate.
  • Requires candidates be Board Certified (or eligible) in Internal Medicine or Family Medicine.
  • At least 5-7 years clinical experience practicing medicine, with at least 2 years in an administrative capacity.
  • Around 2-3 years’ experience working for a Payer Organization (Health Plan/IPA/HMO/TPA/etc).
  • Substantial knowledge of mental health and chemical dependency services and practices, including a broad band of treatment techniques, procedures, and discharge planning.
  • Excellent written and verbal communication skills; and strong critical thinking, deductive reasoning and decision making skills are needed.
  • Ability to implement complex programs and to monitor implementation and modifications.
 
Senior Medical Director Duties:
 
  • Build credible and trusting relationships with stakeholders regarding performance metrics.
  • Serve as liaison for the health plan to ensure that all the opportunities are highlighted through detailed reporting to the leadership at the groups.
  • Individually own and lead initiatives that ties to cost savings to the department.
  • Serve as the clinical lead with large employer groups in the bid process. 
  • Manage assigned departments or functions with an emphasis on execution, outcomes, continual improvement and performance enhancement.
  • Maintain relationships with key employer groups, physician groups, individual physicians, managed care organizations, and state medical associations and societies.
  • Participate in quality improvement programs to assure that members receive timely, appropriate, and accessible health care.
  • Provide ongoing compliance with standardized systems, policies, programs, procedures, and workflows.
  • Analyze member and population data to guide and manage program direction such as ensuring that members enroll in clinical programs indicated by their clinical need and monitor performance.
  • Participate in the administration of medical management programs to assure that network providers deliver and Plan members receive appropriate, high quality, cost effective care.
  • Assure compliance with all regulatory, accreditation, and internal requirements and audits.
  • Articulate plan policies and procedures to providers and organizations and works to ensure effective implementation of policies and programs.
  • May serve as a member on quality and/or care management programs and committees as directed.
RON AMODIO
STRATEGIC DIRECTOR
CareNational
ron@carenational.com
480.269.9491 (CALL – TEXT – FAX)
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