Our client, one of the nation’s leading health benefits companies, seeks a Medical Director to join a new group that is being formed to support members enrolled in the Minnesota Medicaid Program. Based from their office in Eagan, MN, this medical director will be responsible for the administration of medical management services for company health plans and ensuring the clinical integrity of broad and significant clinical programs, including the overall medical policies of the Medicaid business unit.

Primary duties may include, but are not limited to:

• Evaluates requests for service coverage for medical necessity
• Interprets existing policies and develops new policies based on changes in the healthcare or medical arena
• Leads, develops, directs and implements clinical and non-clinical activities that impact health care quality cost and outcomes
• Supports the Medical Management staff ensuring timely and consistent responses to members and providers
• Identifies and develops opportunities for innovation to increase effectiveness and quality
• Serves as a resource and consultant to other areas of the company
• May chair or serve on company committees
• May be required to represent the client to external entities and/or serve on external committees

Qualifications:

• MD or DO with a minimum of 5 years of post-residency clinical experience – Internal Medicine, Surgery, Pediatrics or OBGYN preferred
• Unrestricted Minnesota license
• Current ABMS recognized board certification
• Previous UM/appeals experience preferred

Compensation:

• Competitive salary
• Full benefits

Join us and together we will drive the future of healthcare.