Manager Medical Director
Company: Max Populi, LLC
Location: Waukesha
Posted on: September 12, 2020
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Job Description:
Join a growing team of medical management professionals at one
of the fastest healthcare companies in the country. This division
is one of the fastest growing businesses in a company with the
largest and most successful Medicaid business in the nation. This
is an exceptional opportunity to do innovative work that means more
to you and those we serve at one of America's leading health
benefits companies and a Fortune Top 50 Company. RELOCATION
AVAILABLE Responsible for the administration of medical services
for company health plans including the overall medical policies of
the business unit to ensure the appropriate and most cost effective
medical care is received and for the day-to-day management of
medical management staff. Primary duties : Interprets existing
policies and develops new policies based on changes in the
healthcare or medical arena. Leads, develops, directs and
implements clinical and non-clinical activities that impact health
care quality cost and outcomes. Identifies and develops
opportunities for innovation to increase effectiveness and quality.
Serves as a resource and consultant to other areas of the company,
may chair or serve on company committees, may be required to
represent the company to external entities and/or serve on external
committees, conduct peer clinical and/or appeal case reviews and
peer to peer clinical reviews with attending physicians or other
ordering providers to discuss review determinations, provides
guidance for clinical operational aspects of the program. Supports
the medical management staff ensuring timely and consistent
responses to members and providers. Hires, trains, coaches,
counsels, and evaluates performance of direct reports and directly
supervises the management of any assigned staff. Qualifications:
Requires M.D. or D.O.; Board certification approved by the American
Board of Medical Specialties required where applicable to duties
being performed, Must possess an active unrestricted medical
license to practice medicine or a health profession.
Keywords: Max Populi, LLC, Waukesha , Manager Medical Director, Other , Waukesha, Wisconsin
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