230, 000 : 270, 000 Medical Director:
Boston, MA or Bedford, NH Join an INNOVATIVE organization that is truly dedicated to improving lives with their integrated careprograms.
This organizations success is due in part to a close collaboration with the provider community and effectively using community resources.
UNLIMITED opportunity to contribute new ideas and grow.
Excellent benefits and a very competitive compensation package.
Participating as an active member of the Integrated Care Team, the Medical Director will serve as the SME for behavioral/mental health issues.
You will provide physician leadership for utilization management activities, organizational determinations, and medical review activities pertaining to utilization review, quality assurance, medical review of complex, and controversial or experimental medical services.
You will conduct case reviews and appeals; facilitate Grand Rounds and case reviews with other clinician and external treating providers.
In collaboration with the VP of Clinical Programs, develops clinical programs and approaches targeted to improve health outcomes for complex care and high acuity populations.
Identify utilization review studies and evaluates adverse trends in utilization of medical services, unusual provider practice patterns, and adequacy of benefit/payment components.
Identify clinical quality improvement studies to assist in reducing unwarranted variation in clinical practice in order to improve the quality and cost of care.
We are interviewing candidates who are MDs or DO s, Board Certified, preferably in a primary care specialty.
Ideal candidate will also be a board certified psychiatrist.
Previous experience within a managed care organization is helpful.
The candidate must be an actively practicing physician, willing to see patients a few hours per month.
NH and/or MA license or willingness to obtain during the onboarding