- Job Level:
Our client is seeking a full-time Medical Director. Their programs include a Managed Long-Term Care program (MLTC), Fully Integrated Dual Advantage (FIDA) program, Institutional Special Needs Program (I-SNP) and Medicaid Advantage Plus program (MAP). Collectively, Health Plans help care for 15,000 members.
- Is responsible for the quality assurance program. He/she chairs the Quality Assurance Committee, appoints its members and sets the agenda.
- He/she identifies opportunities for improvement and leads to the development of projects to improve health outcomes.
- He/she chairs the Medical Advisory Committee which suggests and evaluates clinical practice recommendations.
- He/she is also a member of the Corporate Compliance Committee.
- The Medical Director develops policies and procedures related to care, develops practice guidelines and describes their appropriate use, assures compliance with state and federal regulatory requirements for medical care, participates in the training and education of staff, and reviews and discusses problematic cases with physicians, nurses, nurse care managers and other providers to change and improve treatment plans.
Experience & Skills Required
- This position reports to the Executive Vice President of Health Plans.
- The ideal candidate must possess a current NYS license and registration; MD degree from an accredited medical school; Board Certification (Internal Medicine a plus); familiarity with Medicare and Medicaid regulations and reporting requirements; experience in a medical/healthcare management capacity, and good verbal and written communication skills.