Medical Director, Operations, Ortho/Spine

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Requirements:

• Completed US-based residency program in Orthopedic Surgery; Spine surgery fellowship training or extensive clinical experience required
• Board certification as an MD or DO with a current unrestricted state license to practice medicine - must maintain necessary credentials to retain the position
• 5+ years of clinical practice beyond residency/fellowship
• Able to multitask and manage tasks to completion on a timely basis and in an organized fashion
• Excels in a matrix organization
• Strong interpersonal, oral and written communication skills
• Ability to work remotely and meet telephonically and/or via video with clinical colleagues and other personnel
• Proficient in using a Mac laptop computer and the Google Workspace of applications
• Comfortable with technology - willing and able to learn new software tools
• Understanding of managed care regulatory structure and processes
• Detail-oriented, flexible, and able to work autonomously with little supervision

Responsibilities:

• Lead a team of Orthopedic Surgery and Spine Surgery Associate Medical Directors responsible for prior authorization clinical reviews and peer-to-peer discussions
• Inspire and motivate team members to perform at their best
• Demonstrated ability to oversee and collaborate with staff
• Proven experience managing a remote workforce and operating efficiently in a virtual environment
• Identify potential problems and points of friction and working to find solutions in order to maximize efficiency and revenue
• Develop and document standard operating procedures
• Demonstrate the highest level of professionalism, accountability, and service in your interactions with Cohere teammates and providers
• Support the clinical guidelines team in developing and reviewing the company’s clinical decision guidelines in conjunction with client guidelines and directives
• Perform timely review of Medical Coverage Policies for our clients
• Participate in internal and external audits of physicians and nurses
• Participate in recruiting of AMDs as business needs grow
• Participate in developing and implementing of physician training
• Support MSK strategy team focused on Spine strategy. This includes new strategy around site of service, level of care, temporary codes, G&A alignment, policy work and other areas such as reviewer efficiency enhancements, client facing meetings, etc.
• Help to promote and maintain professional relationships or partnerships with Spine medical specialty societies, specifically NASS.
• Be willing to travel as needed for client facing meetings or strategic onsite meetings
• Maintain awareness of any changes in the literature, standard of care, or regulatory guidance impacting the criteria by which the company reviews service requests
• Maintain necessary credentials and immediately informs Cohere of any adverse actions relating to medical licenses and/or board certifications
• Perform other duties as delegated