MEDICAL DIRECTOR-West Virginia
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SUMMARY OF POSITION
The French Group has been retained by our client, one of the nations largest health plans, to assist in the selection of an additional medical director. The Medical Director will work closely with the existing team of talented physician executives and will routinely interface with other teams such as care management, pharmacy, network, sales and medical economics. The Medical Director will be responsible for making medical necessity and other benefit coverage determinations in compliance with medical policies, protocols, product designs, and professional judgment. She/he will also participate in Quality and Clinical Management Committees. The Medical Director will make recommendations for clinical product and program development, including providing medical advice, input, and support to the full spectrum of Clinical Management activities and programs. She/he will also collaborate with local area medical leaders as needed and assist with the development of provider networks and partnerships.
-Active, unrestricted licensure as an MD or DO and current ABMS Board Certification.
-A minimum of five years clinical experience, post-residency, preferably managing both inpatient and outpatient care.
-At least three years experience in managed care, utilization review and/or quality management is desirable.
-Knowledge of current and emerging medical treatment modalities.
-Familiarity with National Committee for Quality Assurance and American Accreditation HealthCare Commission/URAC standards.
-Demonstrated public speaking and written communication skills.
For additional information and/or confidential consideration, please contact Tricia French at email@example.com or 757-362-0202.