Medical Director, Ohio Market
New
United StatesFull-TimeDirector
Salary$191,400.00 - $334,900.00
Apply NowOpens the employer's application page
Job Details
- Experience
- Minimum of five (5) years of clinical practice experience
- Required Skills
- Data Analysis
Requirements
- Completion of an accredited Medical Degree program (MD or DO).
- Successful completion of a residency training program.
- Board Certification in a medical specialty.
- Maintained re-certification as required by specialty board.
- Minimum of five (5) years of clinical practice experience.
- Current, unrestricted license to practice medicine in the state of practice.
- Proficiency in Microsoft Word.
- Excellent written and oral communication skills.
- Strong analytical skills for evaluating physician practice patterns.
- Demonstrated leadership experience and skills.
- Ability to work independently and within a team environment.
Responsibilities
- Collaborate with market and product leaders to define market strategy.
- Represent the organization at state and regulatory venues.
- Perform prior authorization medical reviews and clinical consultation.
- Conduct clinical reviews for health plan members.
- Identify and address utilization management trends.
- Provide provider education, training, and performance evaluations.
- Participate in peer-to-peer discussions and clinical case reviews.
- Support quality improvement plans and market-level initiatives.
- Investigate cases of suspected fraud, abuse, or quality of care concerns.
View Full Description & ApplyYou'll be redirected to the employer's site
