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
29 Smartdocs Direct Jobs Hiring Near You
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 Neurosurgery Physician Neurosurgeon 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 Neurosurgery Physician Neurosurgeon 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 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.
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.
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 ...
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 ...
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 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 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 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 Cardiology Physician Noninvasive Cardiologist practice is seeking a qualified physician for Tallahassee, FL. This and other physician jobs brought to you by ExactMD.
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 ...
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 ...
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 ...
Medical Doctors Only Apply. A Family Practice Physician Traditional Practitioner practice is seeking a qualified physician for Orlando, FL. This and other physician jobs brought to you by ExactMD.
Medical Doctors Only Apply. A Family Practice Physician Traditional Practitioner practice is seeking a qualified physician for Orlando, FL. This and other physician jobs brought to you by ExactMD.
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 ...
Medical Doctors Only Apply. A Radiology Physician Neurological Radiologist practice is seeking a qualified physician for Port Charlotte, FL. This and other physician jobs brought to you by ExactMD.
Medical Doctors Only Apply. A Radiology Physician Neurological Radiologist practice is seeking a qualified physician for Port Charlotte, FL. This and other physician jobs brought to you by ExactMD.
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 ...
Internal Medicine Physician General Internist - Physicians Only Apply - Perm
Indianapolis, IN
SmartDocs Direct
Full-time
Re-posted 10 days ago
Job description
Medical Doctors Only Apply. A Internal Medicine Physician General Internist practice is seeking a qualified physician for Indianapolis, IN. 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.