Associate Medical Director

2 days ago


Dallas, Texas, United States Adelphi Staffing Full time

Job Quick Facts: • Specialty: OB/GYN – Associate Medical Director • Job Type: Locum to Perm • Facility Location:  Dallas, TX • Service Setting: Administrative • Reason For Coverage: Supplemental • Coverage Period: 13 weeks • Coverage Type: Clinical only • Shift Schedule: Mon - Fri; 8a -5p • Support Staff: Multidisciplinary teams within managed care and clinical operations • Core Responsibilities:       – Review prior authorization & appeals for medical necessity       – Peer -to -peer provider reviews       – Clinical oversight for UM, disease management, and quality management       – Develop medical policies, clinical guidelines, and coverage rules       – Analyze provider performance data       – Review provider applications and quality concerns       – Oversight of; pharmacy benefit coordination,fraud, waste, and abuse clinical aspects       – Participate in regulatory interactions (state/local agencies), managed care committees       – Support development & monitoring of annual organizational goals       – Evaluate job design, workflows, and processes for improvement       – Ability to interpret/understand Texas Medicaid regulations       – Demonstrate leadership, communication, and managed -care–oriented skills      –  Application of medical knowledge within operational/business environments • Other Info: Locum -to -perm transition expected • Travel, lodging, and malpractice insurance covered Requirements: • Active TX License (or willingness to obtain) • Board Certified in OB/GYN • Clean malpractice/license history



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