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 ...
SmartDocs Direct
29 Smartdocs Direct Jobs Hiring Near You
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 ...
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 ...
Psychiatry Physician General Psychiatrist - Physicians Only Apply - Perm
Fort Walton Beach, FL · On-site
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.
Psychiatry Physician General Psychiatrist - Physicians Only Apply - Perm
Fort Walton Beach, FL · On-site
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 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 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.
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 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 ...
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 ...
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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Full-time
Posted 7 days ago
Job description
Medical Doctors Only Apply. A Administrative Physician practice is seeking a qualified physician for Linthicum Heights, MD. This and other physician jobs brought to you by ExactMD.
Position Purpose: 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 vision and attendant policies and procedures.
Serves as clinical advisor to and educator of medical management staff making sure correct clinical judgment is applied to all medical management determinations.
Oversees internal medical review guidelines to ensure clinical integrity and compliance and acts as a resource for staff members throughout the operation.
Coordinates with other departments, the responses needed to address regulatory accreditation concerns pertaining to medical management issues
Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services.
Facilitates the achievement of the Medical Management Program goals through an effective health services delivery system.
Responsible for physician review and oversight of all potential adverse determinations including pre-certifications/prior authorizations, concurrent review and appeals/retrospective review.
Responsible for HEDIS improvement and strategy.
Actively participates in the auditing process of medical management processes and corrective action team projects for medical management
Achieves utilization, cost management and quality goals.
Participates and advises in the development of corporate medical policies for UM, pharmacy, and new technology
For Home State Health Plan only – responsible for the sufficiency and supervision of the health plan provider network
Education/Experience: Medical Doctor or Doctor of Osteopathy, board certified in a specialty recognized by the American Board of Medical Specialists. Volunteer patient care required. Previous experience as Medical Director is preferred. Master’s degree in Business Administration, Public Health, Healthcare Administration or related field preferred.
For Immediate Consideration, Please Inquire Within
Chief Medical Director Opportunity in Maryland:
Job description
For Home State Health Plan only – responsible for the sufficiency and supervision of the health plan provider network