Position Purpose: Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. * Provides medical ...
SmartDocs Direct
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Position Purpose: Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. * Provides medical ...
Direct and coordinate the medical management, quality improvement and credentialing functions for the assigned business unit based on, and in support of the strategic plan, establishing the strategic ...
Direct and coordinate the medical management, quality improvement and credentialing functions for the assigned business unit based on, and in support of the strategic plan, establishing the strategic ...
Job Summary The Medical Director of Care Management Services will develop, manage and implement the newly formed care management and coordination services program for members. As one of the largest ...
Job Summary The Medical Director of Care Management Services will develop, manage and implement the newly formed care management and coordination services program for members. As one of the largest ...
Position Purpose: Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. * Provides medical ...
Position Purpose: Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. * Provides medical ...
Position Purpose: Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. * Provides medical ...
Position Purpose: Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. * Provides medical ...
Job Summary The Medical Director of Care Management Services will develop, manage and implement the newly formed care management and coordination services program for members. As one of the largest ...
Job Summary The Medical Director of Care Management Services will develop, manage and implement the newly formed care management and coordination services program for members. As one of the largest ...
Job Summary The Medical Director of Care Management Services will develop, manage and implement the newly formed care management and coordination services program for members. As one of the largest ...
Job Summary The Medical Director of Care Management Services will develop, manage and implement the newly formed care management and coordination services program for members. As one of the largest ...
Medical Doctors Only Apply. A Neurology Physician Stroke Medicine practice is seeking a qualified physician for Tallahassee, FL. This and other physician jobs brought to you by ExactMD. Seeking a ...
Medical Doctors Only Apply. A Neurology Physician Stroke Medicine practice is seeking a qualified physician for Tallahassee, FL. This and other physician jobs brought to you by ExactMD. Seeking a ...
Medical Doctors Only Apply. A Internal Medicine Physician General Internist practice is seeking a qualified physician for Orlando, FL. This and other physician jobs brought to you by ExactMD. Great ...
Medical Doctors Only Apply. A Internal Medicine Physician General Internist practice is seeking a qualified physician for Orlando, FL. This and other physician jobs brought to you by ExactMD. Great ...
Position Purpose: Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. * Provides medical ...
Position Purpose: Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. * Provides medical ...
Position Purpose: Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. * Provides medical ...
Position Purpose: Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. * Provides medical ...
Position Purpose: Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. * Provides medical ...
Position Purpose: Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. * Provides medical ...
Cardiology Physician Noninvasive Cardiologist - Physicians Only Apply - Perm
$299.10K - $337.90K/yr
Medical Doctors Only Apply. A Cardiology Physician Noninvasive Cardiologist practice is seeking a qualified physician for Tallahassee, FL. This and other physician jobs brought to you by ExactMD.
Cardiology Physician Noninvasive Cardiologist - Physicians Only Apply - Perm
$299.10K - $337.90K/yr
Medical Doctors Only Apply. A Cardiology Physician Noninvasive Cardiologist practice is seeking a qualified physician for Tallahassee, FL. This and other physician jobs brought to you by ExactMD.
Medical Doctors Only Apply. A Critical Care Physician Intensivist practice is seeking a qualified physician for Ocala, FL. This and other physician jobs brought to you by ExactMD. A rapidly growing ...
Medical Doctors Only Apply. A Critical Care Physician Intensivist practice is seeking a qualified physician for Ocala, FL. This and other physician jobs brought to you by ExactMD. A rapidly growing ...
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Medical Doctors Only Apply. A Psychiatry Physician General Psychiatrist practice is seeking a qualified physician for Fort Walton Beach, FL. This and other physician jobs brought to you by ExactMD.
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Medical Doctors Only Apply. A OBGYN Physician General obstetrics and Gynecology practice is seeking a qualified physician for Ocala, FL. This and other physician jobs brought to you by ExactMD. The ...
Medical Doctors Only Apply. A General Pediatric Physician practice is seeking a qualified physician for Jacksonville, FL. This and other physician jobs brought to you by ExactMD. Join one of the ...
Medical Doctors Only Apply. A General Pediatric Physician practice is seeking a qualified physician for Jacksonville, FL. This and other physician jobs brought to you by ExactMD. Join one of the ...
Medical Doctors Only Apply. A General Pediatric Physician practice is seeking a qualified physician for Fort Lauderdale, FL. This and other physician jobs brought to you by ExactMD. Join one of the ...
Medical Doctors Only Apply. A General Pediatric Physician practice is seeking a qualified physician for Fort Lauderdale, FL. This and other physician jobs brought to you by ExactMD. Join one of the ...
Medical Doctors Only Apply. A Otolaryngology Physician Otolaryngologist (ENT Physician) practice is seeking a qualified physician for Tampa, FL. This and other physician jobs brought to you by ...
Medical Doctors Only Apply. A Otolaryngology Physician Otolaryngologist (ENT Physician) practice is seeking a qualified physician for Tampa, FL. This and other physician jobs brought to you by ...
Rheumatology Physician Rheumatologist - Physicians Only Apply - Perm
$236.70K - $305.40K/yr
Medical Doctors Only Apply. A Rheumatology Physician Rheumatologist practice is seeking a qualified physician for Gainesville, FL. This and other physician jobs brought to you by ExactMD. Currently ...
Rheumatology Physician Rheumatologist - Physicians Only Apply - Perm
$236.70K - $305.40K/yr
Medical Doctors Only Apply. A Rheumatology Physician Rheumatologist practice is seeking a qualified physician for Gainesville, FL. This and other physician jobs brought to you by ExactMD. Currently ...
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Family Practice Physician Traditional Practitioner - Physicians Only Apply - Perm
SmartDocs DirectDes Moines, IA
Full-time
Posted 21 days ago
Job description
Medical Doctors Only Apply. A Family Practice Physician Traditional Practitioner practice is seeking a qualified physician for Des Moines, IA. This and other physician jobs brought to you by ExactMD.
Provides
medical leadership of all for utilization management, cost containment,
and medical quality improvement activities. Performs medical review
activities pertaining to utilization review, quality assurance, and
medical review of complex, controversial, or experimental medical
services. Supports effective implementation of performance improvement
initiatives for capitated providers.
Assists Chief Medical
Director in planning and establishing goals and policies to improve
quality and cost-effectiveness of care and service for members. Provides
medical expertise in the operation of approved quality improvement and
utilization management programs in accordance with regulatory, state,
corporate, and accreditation requirements.
Assists the
Chief Medical Director in the functioning of the physician committees
including committee structure, processes, and membership. Oversees the
activities of physician advisors. Utilizes the services of medical and
pharmacy consultants for reviewing complex cases and medical necessity
appeals. Participates in provider network development and new market
expansion as appropriate. Assists in the development and implementation
of physician education with respect to clinical issues and policies.
Identifies utilization review studies and evaluates adverse trends in
utilization of medical services, unusual provider practice patterns, and
adequacy of benefit/payment components. Identifies clinical quality
improvement studies to assist in reducing unwarranted variation in
clinical practice in order to improve the quality and cost of care.
Interfaces with physicians and other providers in order to facilitate
implementation of recommendations to providers that would improve
utilization and health care quality. Reviews claims involving complex,
controversial, or unusual or new services in order to determine medical
necessity and appropriate payment.
Develops alliances with
the provider community through the development and implementation of the
medical management programs. As needed, may represent the business unit
before various publics both locally and nationally on medical
philosophy, policies, and related issues. Represents the business unit
at appropriate state committees and other ad hoc committees
Consults on MCO clinical policy related to Substance Use Disorders and
the cases of individual members for the MCM program on a routine basis.
Education/Experience: Medical Doctor or Doctor of Osteopathy, board certified preferable in a primary care specialty (Internal Medicine, Family Practice, Pediatrics or Emergency Medicine). The candidate must be an actively practicing physician. Previous experience within a managed care organization is preferred. Course work in the areas of Health Administration, Health Financing, Insurance, and/or Personnel Management is preferred. Experience treating or managing care for a culturally diverse population preferred.
Position Purpose: Assist the Chief Medical Director to
direct and coordinate the medical management, quality improvement and
credentialing functions for the business unit.
Education/Experience: Medical Doctor or Doctor of Osteopathy, board certified preferable in a primary care specialty (Internal Medicine, Family Practice, Pediatrics or Emergency Medicine). The candidate must be an actively practicing physician. Previous experience within a managed care organization is preferred. Course work in the areas of Health Administration, Health Financing, Insurance, and/or Personnel Management is preferred. Experience treating or managing care for a culturally diverse population preferred.