Mass General Brigham connects a full spectrum of care across a system of academic medical centers, specialty and community hospitals, physician networks, a heal
Health Plan Medical Director
Location
United States
Posted
68 days ago
Salary
$285K - $325K / year
Seniority
Lead
No structured requirement data.
Job Description
Health Plan Medical Director
Mass General Brigham
Site: Mass General Brigham Health Plan Holding Company, Inc. Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. The salary range for this position is $285,000.00 to $325,000.00 annually. At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will consider your skills, relevant experience, if applicable, education, certifications, and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums, and bonuses as applicable, and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package. Job Summary Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are on the forefront of transformation with one of the world’s leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage. Our work centers on creating an exceptional member experience – a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise. We are pleased to offer competitive salaries, and a benefits package with flexible work options, career growth opportunities, and much more. Under the direction of the Senior Medical Director, the Medical Director leads as a senior physician at the health plan. This position works closely with the Senior Medical Director in providing medical management leadership for clinical services operations and programs. This role focuses on and has expertise in utilization management, health plan quality and accreditation, care management, and other health plan functions. Qualifications Licenses and Credentials Physician License. Must hold or be able to obtain a full active Massachusetts physician license. Needs 3-5 years of Health Plan experience - Must have prior experience in utilization management, peer to peer discussions - Collaborates with business development, quality, finance, and medical management teams to promote improvements in the quality and cost efficiency of care throughout Mass General Brigham Health Plan provider network. - Partners with clinical leaders to ensure medical service expenditures remain within budget. - Aids in crafting Mass General Brigham Health Plan's clinical programs and policies. - Collaborates with the CMO in the development and physician oversight of disease management programs. - Handles initial determinations, appeals and grievances within the scope of their expertise as defined by MassHealth, Medicare, NCQA and the Division of Insurance and within the compliance requirements of key regulatory and accreditation entities. - Reviews clinical service and quality incidents when sufficiently serious to merit physician involvement. - Assesses new, emerging, and existing technologies to determine appropriateness of health plan coverage. - Supports the clinical, network, and operations staff to ensure end to end consistency of clinical policies, payment policies and claims payment. - Develops and delivers presentations for clinical staff on current topics relevant to Mass General Brigham Health Plan members and network. - Administers case and condition consultation to Utilization Management and Care Management staff. - Delivers consultation to network management staff and deployment of education programs for network clinicians. - Serves as a member of the following Mass General Brigham Health Plan Committees or workgroups: Clinical Policy & Quality, Patient Care Assessment, Credentialing, Utilization Management, Medical Economics and Behavioral Health Oversight. - May represent Mass General Brigham Health Plan at a variety of external forums and committees. - Anticipates and meets, or exceeds, internal and/or external customer expectations and requirements; establishes and maintains positive relationships with customers and gains their trust and respect. - Hold self and others accountable to meet commitments. - Persist in accomplishing objectives to consistently achieve results despite any obstacles and setbacks that arise. - Build strong relationships and infrastructures that designate Mass General Brigham Health Plan as a people-first organization. - Other duties as assigned with or without accommodation. Additional Job Details (if applicable) Virtual position. Full time. In person meetings as requested for business needs. Participates in after hours and weekend call rotation as assigned. Remote Type Remote Work Location 399 Revolution Drive Scheduled Weekly Hours 40 Employee Type Regular Work Shift Day (United States of America) EEO Statement: 8925 Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran’s Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642. Mass General Brigham Competency Framework At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.
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The Company, at its sole discretion, will determine what constitutes as equivalent to the qualifications described above. Further, nothing contained herein should be construed to create an employment contract. Occasionally, required skills/experiences for jobs are expressed in brief terms. Any language contained herein is intended to fully comply with all obligations imposed by the legislation of each country in which it operates, including the implementation of the EU Equality Directive, in relation to the recruitment and employment of its employees. The Company is committed to compliance with the Americans with Disabilities Act, including the provision of reasonable accommodations, when appropriate, to assist employees or applicants to perform the essential functions of the job. 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The Company, at its sole discretion, will determine what constitutes as equivalent to the qualifications described above. Further, nothing contained herein should be construed to create an employment contract. Occasionally, required skills/experiences for jobs are expressed in brief terms. Any language contained herein is intended to fully comply with all obligations imposed by the legislation of each country in which it operates, including the implementation of the EU Equality Directive, in relation to the recruitment and employment of its employees. The Company is committed to compliance with the Americans with Disabilities Act, including the provision of reasonable accommodations, when appropriate, to assist employees or applicants to perform the essential functions of the job.
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Medical Science Liaison (MSL) -Maternal-Fetal Immunology
Amplity HealthA pure-play pharmaceutical commercialization company helping clients navigate the road from product to patient.
Join Amplity, the full-service go-to partner of biopharma companies that delivers flexible + specialized medical + commercial services. No matter where a drug is in its lifecycle, we scale with ease to maximize resources + improve impact for all our clients. Through strategic partnerships + deep therapeutic expertise, Amplity transforms how breakthrough treatments reach the people who need them. Medical Science Liaison (MSL) -Maternal-Fetal Immunology US Use your MSL/CTL, experience in an exciting new role. As an Amplity employee representing one of our top clients, a competitive base salary, bonus potential, auto allowance, full benefit package including medical, dental, vision, 401K, company funded long-term, short-term, disability, life insurance, mental wellness program, generous PTO, paid holidays and more. If you have experience in the OBYGN, maternal health field and MSL/CTL experience we would like to hear from you. US based. Employees can expect to be paid a salary of approximately $205K - $220K. The salary range displayed may vary based on market data/ranges, an applicant's skills, prior relevant experience, certain degrees, certifications, and other relevant factors. Summary The MFI Medical Science Liaison (MSL) has a specialized focus that complements Medical Science Liaison (MSL)/ Clinical Trial Liaison (CTL) responsibilities. The key aspects and objectives of this role are: - Support and enhance the enrollment of ongoing clinical studies, specifically in rare maternal-fetal diseases. - The primary focus is on increasing recruitment into ongoing Phase 3 trials. - Relationship Building: Establish and maintain strong relationships with healthcare professionals (HCPs) and key opinion leaders (KOLs) in the Maternal-Fetal Immunology space. - Identify and build relationships with KOLs in adjacent specialties, including neonatology, pediatric hematology, and transfusion medicine, to support disease and trial awareness within institutions that are. - Disease and Trial Awareness: Drive awareness of both the rare diseases being studied and the associated clinical trials and disease registries. - Scientific Collaboration: Foster collaboration with HCPs and other stakeholders to support educational and data generation activities, ensuring alignment with scientific and organizational goals. - Market Development: Engage and educate markets that may have limited familiarity with rare maternal-fetal diseases, including the introduction of new prenatal testing options, thus expanding the reach, and understanding of these areas. - Scientific Insights: Collect valuable feedback and insights from the medical community to inform trial strategies and improve program outcomes. - Non-Promotional Information Dissemination: Share accurate and relevant medical and scientific information in a non-promotional manner to support trial and disease awareness. The MFI MSL plays a critical role in the success of the program by ensuring high scientific standards, fostering collaboration, and aligning with the organization's broader strategies. Key Responsibilities - Collaborate with the Director of MSLs to execute the overall program strategy, ensuring alignment with MSL/CTL organizational objectives. - Boost recruitment into the Phase 3 trials - Build and maintain trusted relationships with healthcare professionals, key opinion leaders (KOLs), clinical trial investigators/sites, and other stakeholders in assigned region. - Gather and report scientific insights from the field to inform cross-functional teams and support organizational decision-making. - The MSLs will support AZALEA, FREESIA, GERANIUM (the global HDFN registry), and PETUNIA (the MG pregnancy registry). - Engaging in the exchange of scientific data and other medical and/or scientific information with external stakeholders - Represent the organization at scientific meetings, conferences, and advisory boards as needed. - Serve as a subject matter expert staying current with relevant scientific literature, clinical guidelines, and advancements. - Support for strategic initiatives across Medical Affairs, Clinical Development, and other internal teams. - Act as a liaison between internal teams and external stakeholders to support scientific exchange and collaboration. - Operate with the highest ethical and professional standards, adhering to all applicable laws, regulations, and organizational policies. - Ensure that all MSL and Clinical Trial activities are conducted in compliance with relevant guidelines and regulations. Qualifications - Advanced degree e.g., Ph.D, Pharm. D, MD, MSN, NP/PA or equivalent education required from an accredited institution required. - MFM or OBGYN, experience either as an MSL or in clinical setting strongly preferred. - Neonatology or Hematology experience is also acceptable. - MSL/CTL experience desired. - Strong knowledge of clinical and scientific principles in the Obstetrics/Gynecology Neonatology, Maternal/Fetal Health desired. - Understanding of the clinical trial processes and the ability to provide support to clinical research initiatives. - Exceptional communication and interpersonal skills, with the ability to present scientific information and build new markets, is important. - Skilled at building and maintaining key relationships with healthcare professionals and key opinion leaders. - Strong clinical acumen, high learning agility a self-initiative needed. - Excellent organizational and time-management skills, with a results-oriented mindset. - Ability to work independently and collaboratively in a dynamic, fast-paced environment. - Willingness to travel 70% within the assigned multiple state region needed. - Excellent technology skills e.g., PowerPoint, Excel, digital meeting platforms - Valid driver's license with safe driving record required. - Successfully pass all required Amplity and client training EPIIC Values: All positions at Amplity have a responsibility to demonstrate our EPIIC Values in order to uphold our high-service standards. Excellence: We set high standards. We are solutions-focused and achieve outstanding results with a professional and positive attitude. Passion: We love what we do. Our energy inspires, engages, and motivates others. Innovation: Our ideas set us apart. We are curious and bold and challenge traditional ways of working. Integrity: We are open, honest, and transparent. We do the right thing with courage and understanding. Collaboration: We are better together. We actively seek the participation of others to achieve greater outcomes. About Us Amplity powers biopharma innovation through expert-led teams that deliver. Whether you knew us in the 80’s as Physician Detailing Inc., or in the 00’s as part of Publicis Health , the companies that came together in 2019 to form Amplity have delivered contract medical, commercial + communications excellence for 40+ years. Our people-driven, tech-enabled DNA fuels everything we do. Our professionals understand the pharmaceutical industry from the inside out. With a deep grasp on product lifecycles, marketing hurdles, operational nuances + the complex needs of providers and patients, we help our clients launch products + operate smoothly with precision — across all business shapes, sizes + specialties. We are on a mission to improve patient outcomes through executional excellence — enabling our partners in pharma to thrive in turn. At Amplity, we are allies in excellence. And we do it quicker, better, nicer than anyone else. Our Diversity Policy We encourage and support equal employment opportunities for all associates and applicants for employment without regard to sex, race, color, religion, national origin, age, disability, marital status, sexual orientation or veteran status. Employment decisions are evaluated on the basis of an individual's skills, knowledge, abilities, job performance and other qualifications. In addition, Amplity Health maintains policies and procedures designed to comply with applicable federal, state and local laws governing non-discrimination in employment in every location in which Amplity Health has facilities.




