MEDICAL DIRECTOR – MIDWEST HEALTH PLAN

The French Group has been retained by one of the nation’s most reputable health plans to assist in the selection of their new medical director. This position reports to the Chief Medical Officer—a reflective, seasoned and respected physician executive. The Medical Director is responsible for providing medical management leadership to ensure the delivery of high quality, consumer centric and cost effective medical care. These responsibilities include medical utilization management, medical community relationships, network development and maintenance.

Specific Responsibilities include:

Provides leadership to strategic medical management of markets
• Provides clinical guidance and oversight in operating effective medical management initiatives to achieve member quality of care
• Participation in utilization management practices including concurrent review, discharge planning and case management
• Leadership of quality management activities including those necessary to achieve NCQA accreditation
• Collaborates with practice manager in utilizing data analysis to identify opportunities for quality improvement and to positively influence practice patterns
• Participates in evaluation of product design, impact on quality, cost and service

Serves as critical medical leader for external providers and plan sponsors, including regulatory and accrediting agencies, and community in general
• Key business partner in network development strategy, to maintain member access of high quality medical care and the maintenance of a marketable, high quality, cost effective provider network
• Leader in improving and maintaining positive relations with physicians and hospitals
• Provides value-added support to sales and marketing efforts
• Assures compliance to regulatory requirements and core company policies

Desired Background

• M.D. or D.O. with current Board certification in a recognized specialty
• Active state medical license without encumbrances
• Minimum of 5 years clinical practice experience
• Minimum of 2 years leadership experience in a managed care organization

 

For additional information and/or confidential consideration, please contact:

CONSULTANT: Tricia French, RN, BSN
President & CEO
The French Group
757-362-0202
tfrench@frenchgroup.com