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Senior Health Care Administrator
3 weeks ago
The Senior Medical Director will be responsible for leading our medical management strategies and network programs at Pinnacol Assurance. This is a key role that requires a strong understanding of managed care processes and systems, as well as extensive experience overseeing effective Utilization Review/Authorization Programs.
Responsibilities
- Collaborate with operations leadership to develop and maintain quality and medical management strategies and network programs.
- Develop and implement clinical programs, including value-based programs and incentives, care outcomes, central utilization review, and program integrity.
- Provide strategic input to senior management, clinical staff, physician advisors, regulators, and network providers on changes in accreditation standards, implications of proposed legislation, utilization management criteria, clinical guidelines, delivery system trends, and related issues.
Qualifications
- Current unrestricted Colorado Board of Medical Examiners License (MD or DO).
- Current State of Colorado Division of Workers' Compensation Level I or II Physician.
- Accreditation ABMS or AOA Board Certification in a related specialty.
