Quality Medical Director

2 weeks ago


Jackson, United States Accede Solutions Inc Full time
Job Title: Quality Medical Director
Full Time
Location: Jackson, MS

Primary Function:
As the Quality Medical Director, you will oversee Client's Mississippi Quality Assurance team to ensure the proper provision of program services. You will serve as a clinical liaison for quality management and improvement activities for the FFS and Mississippi CAN programs.

Essential Functions:
Oversee and have accountability for the medical review activities of the organization or assigned contracts.
Conduct critical peer reviews to ensure the health provided is appropriate and necessary.
Instruct other physician reviewers on critical reviews and improvement of health care.
Assist Client staff with training physician reviewers regarding their responsibilities and functions.
Serve as a technical expert on the peer review process.
Participate in advisory panels as recommended.
Represent Client policies and procedures to medical and non-medical persons.
Participate in committee meetings representing Client.

Requirements:
3+ years of managing and/or working with Medicaid, government health plans, or authorization programs.
Current unrestricted MD or DO license in the state of Mississippi.
Current and active, unrestricted United States board certification by the American Board of Medical Specialties or Advisory Board of Osteopathic Medicine.
post-graduate experience in direct clinical patient care.
Experience with Medicaid is highly preferred.

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