Medical Director (Part-Time) (Temporary)
125 - 185 USD per hour
Company:Central California Alliance for Health (Remote)
Location:California, United States
Languages:English
Seniority level:Lead, minimum of three years
Experience:Minimum of three years
Skills:
LeadershipData management
Requirements:
- Doctor of Medicine or Doctor of Osteopathy from an accredited medical school
- Current active and unrestricted license to practice medicine issued by the State of California
- Board certification in a specialty recognized by the American Board of Medical Specialties
- Minimum of three years of experience working in medical programs administration
- Experience with the peer review process
- Knowledge of data collection and management practices related to utilization and quality of medical care
- Knowledge of InterQual and Milliman Care Guidelines
- Knowledge of Managed care, Medi-Cal, Medicaid, and Medicare programs
- Knowledge of Healthcare regulatory processes
- Proficiency with Jiva (or equivalent)
Responsibilities:
- Provide clinical leadership and oversight for Utilization Management (UM)
- Provide clinical leadership and oversight for Potential Quality Issue (PQI)
- Provide clinical leadership and oversight for Provider Disputes
