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Utilization Management Medical Director

Medical DirectorMedical DirectorFull TimeRemoteLeadTeam 1,001-5,000H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

91 days ago

Salary

$223.8K - $313.1K / year

Seniority

Lead

Postgraduate Degree3 yrs expEnglish

Job Description

Utilization Management Medical Director

CenterWell Senior Primary Care

• rely on medical background and review health claims • provide medical interpretation and decisions about the appropriateness of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards • make decisions on moderately complex to complex issues regarding technical approach for project components • exercise considerable latitude in determining objectives and approaches to assignments

Job Requirements

  • MD or DO degree
  • Three years of direct clinical patient care experience post residency or fellowship, which preferably includes some experience in an inpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age)
  • Current and ongoing board certification an approved ABMS medical Specialty, or other board demonstrating advanced training in transitions of care, quality assurance, utilization management and care coordination
  • A current and unrestricted medical license in at least one jurisdiction and willing to obtain additional license
  • No current sanction from Federal or State Governmental organizations, and able to pass credentialing requirements
  • Evidence of analytic and interpretation skills, with prior experience participating in teams focusing on transitions of care, quality management, utilization management, case management, discharge planning and/or home health or post-acute services such as inpatient rehabilitation.

Benefits

  • medical, dental and vision benefits
  • 401(k) retirement savings plan
  • time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
  • short-term and long-term disability
  • life insurance
  • many other opportunities

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