Medical Director

7 hours ago

Pensacola, FL, United States LanceSoft Full time
Job Description

Job Tittle: Medical Director
Location: Remote
Duration: 6+ Months with the potential for hire
Schedule: 40 hours with rotating weekend coverage; participation in weekend work on a rotational basis tensure cases are decisioned in a timely manner
Pay Range: $133.86 - $149.30

Job Description:
  • The Medical Director's work includes reviewing of all submitted medical records, synthesizing complex hospital-based clinical scenarios, and providing expert decisioning on the requested services.
  • They will have regular discussions with external providers by phone tgather additional clinical information and discuss determinations. Medical directors are expected tunderstand Client processes with a focus on collaborative professional relationships.
  • The ideal candidate will have a high degree of integrity, professionalism, resourcefulness, and enjoy working in a team-based environment. Medical Directors support Client value throughout all activities.

Responsibilities:
  • The Medical Director provides medical interpretation and determinations whether services provided by other healthcare professionals are concordant with national guidelines, CMS requirements, Client policies, clinical standards, and (in some cases) contracts.
  • After completion of structured and mentored training, daily work is performed with minimal direction, but with ready support from other team members. The ideal candidate enjoys working in a structured environment with expectations for consistency in thinking and authorship.
  • Exercises independence in meeting departmental expectations and meets compliance timelines.
  • Conduct comprehensive, timely, and compliant medical necessity reviews for inpatient services
  • Maintain accountability for productivity, quality, and compliance metrics
  • Communicate determinations clearly both verbally and in writing
  • Demonstrate adaptability and willingness tlearn evolving workflows, tools, and utilization management practices

Required Qualifications:
  • MD or Ddegree
  • 5+ years of direct clinical patient care experience post residency or fellowship, which preferably includes some experience in an inpatient environment and/or related tcare of a Medicare type population (disabled or? 65 years of age).
  • Current and ongoing Board Certification an approved ABMS Medical Specialty
  • A current and unrestricted license in at least one jurisdiction and willing tobtain additional license, if required.
  • Ncurrent sanction from Federal or State Governmental organizations, and able tpass credentialing requirements.
  • Excellent verbal and written communication skills.
  • Evidence of analytic and interpretation skills, with prior experience working in a team environment
  • Preferred Qualifications
  • Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other medical management organizations, hospitals/ Integrated Delivery Systems, health insurance, or other healthcare providers.
  • Utilization management experience in a medical management review organization, such as Medicare Advantage, Managed Medicaid, or Commercial health insurance.
  • Experience with national guidelines such as MCG®or InterQual
  • Experience in hospital-based clinical practice, including specialties of Internal Medicine, Family Practice, Geriatrics, Hospitalist, Emergency Medicine, and hospital-based clinical specialists
  • The curiosity tlearn and the flexibility tadapt tchanges in order tenhance efficiency, productivity, and organizational goals.
  • Ability tthrive in a dynamic fast-paced, team-oriented environment.
  • Commitment ta culture of innovation, including being facile with using technology timprove workflows
  • Participate in educational activities by attending required conferences and alscreate content tlead/teach/present for individual subject matter contribution
  • Passionate about contributing tan organization's focus on consistency in outcomes, consumer experiences and a highly engaged team culture


Meet Your Recruiter

Prachi Shahi

  • Medical Director Physician

    4 days ago

    Pensacola, FL, United States Inspire Healthcare Full time

    Job Description This is NOT remote or telemedicine role MUST be local to Pensacola, Florida and present at the center Center Medical Directors desired to work 4-6 hours per week Work as an Independent Contractor with great hourly compensation Compensation range$150+hourly Completely flexible schedule Can work on Saturday or Sunday if desired Opportunity to...

  • Medical Director Physician

    2 days ago

    Pensacola, FL, United States Inspire Healthcare Full time

    Job Description This is NOT remote or telemedicine role MUST be local to Pensacola, Florida and present at the center Center Medical Directors desired to work 4-6 hours per week Work as an Independent Contractor with great hourly compensation Compensation range$150+hourly Completely flexible schedule Can work on Saturday or Sunday if desired Opportunity to...

  • Medical Director- Hospice

    1 week ago

    Pensacola, FL, United States VITAS Healthcare Full time

    Job Description The medical director of VITAS fulfills two primary functions, each of which is expected to consume approximately one half of the time and work effort of the position: The medical director has overall responsibility for medical direction of the care and treatment of patients and their families rendered by the hospice care team, and shall...

  • Medical Director ~ Geriatrics ~ Florida

    7 days ago

    Pensacola, FL, United States US HealthCare Careers Full time

    Medical Director ~ Geriatrics ~ Pensacola Nationally accredited Geriatric program seeking a Medical Director for its location in Pensacola, FL. The program is centered on the belief that it is better for the well-being of seniors with chronic care needs and their families to be served in the community whenever possible. Requirements Doctorate Degree: MD or...

  • Medical Director ~ Geriatrics ~ Florida

    1 week ago

    Pensacola, FL, United States US HealthCare Careers Full time

    Medical Director ~ Geriatrics ~ Pensacola Nationally accredited Geriatric program seeking a Medical Director for its location in Pensacola, FL. The program is centered on the belief that it is better for the well-being of seniors with chronic care needs and their families to be served in the community whenever possible. Requirements Doctorate Degree: MD or...

  • Medical Director ~ Geriatrics ~ Florida

    2 weeks ago

    Pensacola, FL, United States US HealthCare Careers Full time

    Medical Director ~ Geriatrics ~ Pensacola Nationally accredited Geriatric program seeking a Medical Director for its location in Pensacola, FL. The program is centered on the belief that it is better for the well-being of seniors with chronic care needs and their families to be served in the community whenever possible. Requirements Doctorate Degree: MD or...

  • Medical Director ~ Geriatrics ~ Florida

    2 weeks ago

    Pensacola, FL, United States US HealthCare Careers Full time

    Medical Director ~ Geriatrics ~ Pensacola Nationally accredited Geriatric program seeking a Medical Director for its location in Pensacola, FL. The program is centered on the belief that it is better for the well-being of seniors with chronic care needs and their families to be served in the community whenever possible. Requirements Doctorate Degree: MD or...

  • Medical Director ~ Geriatrics ~ Florida

    4 days ago

    Pensacola, FL, United States US HealthCare Careers Full time

    Medical Director ~ Geriatrics ~ Pensacola Nationally accredited Geriatric program seeking a Medical Director for its location in Pensacola, FL. The program is centered on the belief that it is better for the well-being of seniors with chronic care needs and their families to be served in the community whenever possible. Requirements Doctorate Degree: MD or...

  • Medical Director ~ Geriatrics ~ Florida

    4 days ago

    Pensacola, FL, United States US HealthCare Careers Full time

    Medical Director ~ Geriatrics ~ Pensacola Nationally accredited Geriatric program seeking a Medical Director for its location in Pensacola, FL. The program is centered on the belief that it is better for the well-being of seniors with chronic care needs and their families to be served in the community whenever possible. Requirements Doctorate Degree: MD or...

  • Medical Director

    1 week ago

    Pensacola, FL, United States Baptist Health Care Full time

    Job Description The Medical Director - Primary Care works in conjunction with the Vice President & President - Physician Enterprise and other clinical and administrative leaders to enhance the value-based performance of Baptist Medical Group (BMG) and Baptist Health Care ACO, LLC, an approved Medicare Shared Savings Program Accountable Care Organization...