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Devoted Health logo
Devoted Health

Devoted Health was founded in 2017 to provide seniors with healthcare plans and personalized health guides using world-class technology. On a mission to make he

Medical Director II, Utilization Management

Location

United States

Posted

112 days ago

Salary

$280K - $345K / year

Seniority

Lead

Postgraduate Degree5 yrs expEnglish

Job Description

Medical Director II, Utilization Management

Devoted Health

• Assists in development and maintenance of an efficient UM program to meet the needs of health plan members commensurate with company values. • Perform clinical reviews (i.e., part A, B, appeals, quality of care) and conduct peer to peer discussions. • Participate in inter-rater reliability activities. • Participate in analysis of utilization data and suggest improvement opportunities. • Provide appropriate mentoring and leadership to clinical teams as well as develop relationships to support growth and fiscal responsibility. • Participate in committees and workgroups to achieve department and corporate objectives. • Provide clinical support and participate in utilization management, quality management, clinical services and care management programs to identify opportunities for improvement and efficiency. • Serves as a clinical resource and subject matter expert to both clinical and non-clinical staff throughout the Devoted Health Plan. • Active participation in acute and post acute clinical rounds. • Conduct discussions with physicians in the Devoted network regarding: medical policies, utilization management, use of resources, and quality.

Job Requirements

  • Doctorate from an accredited school of medicine (M.D.) or osteopathy (D.O) required.
  • Five or more years of clinical practice experience.
  • Three (3) years of previous medical director experience working for a health plan, medical group, or hospital in utilization management or medical management.

Benefits

  • Employer sponsored health, dental and vision plan with low or no premium
  • Generous paid time off
  • $100 monthly mobile or internet stipend
  • Stock options for all employees
  • Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles
  • Parental leave program
  • 401K program
  • And more....

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