Medical Director Associate
4 weeks ago
MedPOINT Management seeks a highly skilled Associate Medical Director to join our team. The ideal candidate will possess a strong background in internal medicine or hospitalist, with a minimum of 5 years of clinical experience.
The Associate Medical Director will be responsible for providing medical interpretation and decisions about appropriateness of services provided by other healthcare professionals in compliance with Utilization Management policies, procedures, and state regulations.
The successful candidate will have excellent interpersonal and communication skills, with the ability to work effectively with all levels of the organization and stakeholders, including Health Plans and physicians.
Key Responsibilities:
- Assist the Medical Director in implementing, supervising, and evaluating Utilization Management requirements
- Formulate UM policies and procedures, including identification of criteria for authorization and review decisions
- Apply knowledge of laws and regulations, government, and insurance benefits to UM decision making
- Review service authorization requests and provide recommendations for utilization review, medical necessity, and appropriateness of care
- Actively review utilization patterns and appropriateness in areas such as emergency department charges, specialist consultations, and downstream utilization of limited access and high utilization medical resources
Requirements:
- M.D. or D.O. degree with current unrestricted medical license in the state of California
- 1+ year experience as an Associate Medical Director
- 5+ years clinical experience in internal medicine or hospitalist
- Access to current criteria and specialists available to group
- Knowledge of current and new regulations on federal, state, and local levels, as well as practice guidelines and standards of practice
MedPOINT Management offers competitive salaries and benefits in a collaborative working environment. If you are a motivated and experienced medical professional looking for a new challenge, please submit your resume and salary requirements to personnel@medpointmanagement.com for consideration.
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