- R 4561_ _ at Cambia Health Solutions in Boise, Idaho, United States Job Description Associate Medical Director or Medical Director (DOE) Remote in ID, OR, WA, UT Experience in a surgical specialty and/or coding experience highly preferred These roles will participate in utilization management, provide clinical leadership and support to clinical teams to ensure our members receive quality, cost effective care yielding optimal outcomes.
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Medical Director: Documentation
4 weeks ago
Trinity Health Boise, United States**Job Requirements** · 1. M.D / D.O. degree required. · 2. A minimum of two years' experience in hospital based medicine with exposure to utilization management and documentation initiatives. · 3. Demonstrated teamwork, performance analysis, presentation, interpersonal, facilitat ...
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System Medical Director Research
3 weeks ago
St. Luke's Health System Boise, United StatesOverview · At St. Luke's Health System, our Research Department is at the forefront of advancing medical knowledge and improving patient care. We are committed to conducting innovative research that translates into real-world solutions and transformative healthcare practices. Our ...
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Regional Medical Director
3 weeks ago
Behavioral Health Solutions Boise, United StatesJob Description · Job DescriptionDescription · Behavioral Health Solutions is seeking a licensed Psychiatrist to join our Idaho practice. · Behavioral Health Solution's (BHS) team of mental health treatment professionals specialized in providing comprehensive behavioral health se ...
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Regional Medical Director
3 weeks ago
Behavioral Health Solutions Boise, United StatesDescription · Behavioral Health Solutions is seeking a licensed Psychiatrist to join our Idaho practice. · Behavioral Health Solution's (BHS) team of mental health treatment professionals specialized in providing comprehensive behavioral health services for adults and geriatric ...
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Director, Medical Director
2 weeks ago
Saint Alphonsus Boise, ID, United StatesSaint Alphonsus is a principal provider of evidence-based, interdisciplinary behavioral health services within the region. Our outpatient practice offers comprehensive evaluation and treatment for most emotional and interpersonal problems for children, adolescents, and adults. We ...
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Medical Director
3 days ago
Centurion Health Boise, United StatesJob DetailsJob LocationID, Boise - Idaho Regional Office - Boise, IDPosition TypeFull-TimeEducation LevelProfessional DegreeJob ShiftDayJob CategoryMedical Physician & Advanced Practice ProviderDescriptionCenturion Health is proud to be the provider ofcomprehensive healthcare ser ...
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Medical Director
4 weeks ago
Centurion Health Boise, United StatesJob Details · Job Location · ID, Boise - Idaho Regional Office - Boise, ID · Position Type · Full-Time · Education Level · Professional Degree · Job Shift · Day · Job Category · Medical Physician & Advanced Practice Provider · Description · Centurion Health is proud to ...
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Medical Director
4 weeks ago
Idaho State Job Bank Boise, United StatesMedical Director - North Central Region - Medicaid at Humana in Boise, Idaho, United States Job Description Become a part of our caring community and help us put health first The Medical Director relies on medical background and reviews health claims. The Medical Director (Staff ...
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Medical Director
4 days ago
Humana Boise, United StatesLocation field must contain 'city, state' or a zip code to perform a radius search (e.g., · Denver, CO · or · City and state must be separated by a comma followed by a space (e.g., · Houston, TX ) · Humana · Medical Director - Gulf South Region · in · Boise , · Idaho · B ...
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Research System Medical Director
2 weeks ago
St. Luke's Health System - Boise, ID Boise, United StatesAt St. Luke's Health System, our Research Department is at the forefront of advancing medical knowledge and improving patient care. We are committed to conducting innovative research that translates into real-world solutions and transformative healthcare practices. Our dedicated ...
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System Medical Director Research
6 hours ago
Idaho State Job Bank Boise, United StatesSystem Medical Director Research at St. Luke's Health System in Boise, Idaho, United States Job Description Overview At St. Luke's, our patients come from all walks of life and so do we We strive to foster an environment that embraces our employees' unique strengths, experiences, ...
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Psychiatry Medical Director Opportunity
3 weeks ago
Trinity Health Boise, United StatesSaint Alphonsus Medical Group (SAMG) has an excellent full-time employment opportunity for a Board Certified or Board Eligible Psychiatrist to lead a growing group in Boise, Idaho. · Saint Alphonsus is a principal provider of evidence-based, interdisciplinary behavioral health s ...
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Sharecare Boise, United StatesSharecare, Inc. · Operations Director- Medical Record Retrieval (Remote) · Boise , · Idaho · Apply Now · Sharecare is the leading digital health company that helps people no matter where they are in their health journey unify and manage all their health in one place. Our com ...
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System Medical Director
2 weeks ago
St. Luke's Health System - Boise, ID Boise, ID, United StatesLuke s Health System, a Top 15 and Idaho's largest health system, seeks a System Medical Director to lead St. Luke s Women s Service Line, to join us in our journey of improving health and lives by delivering exceptional performance and outcomes in safety and quality, access and ...
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System Medical Director
3 weeks ago
St. Luke's Health System - Boise, ID Boise, United StatesSt. Luke s Health System, a Top 15 and Idaho's largest health system, seeks a System Medical Director to lead St. Luke s Women s Service Line, to join us in our journey of improving health and lives by delivering exceptional performance and outcomes in safety and quality, access ...
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Regional Medical Director
3 weeks ago
Behavioral Health Solutions Boise, United StatesDescription · Behavioral Health Solutions is seeking a licensed Psychiatrist to join our Idaho practice. · Behavioral Health Solution's (BHS) team of mental health treatment professionals specialized in providing comprehensive behavioral health services for adults and geriatrics ...
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Regional Medical Director
4 weeks ago
Gilder Search Group Boise, United StatesBehavioral Health Solutions is seeking a licensed Psychiatrist to join our Idaho practice. · Behavioral Health Solution's (BHS) team of mental health treatment professionals specialized in providing comprehensive behavioral health services for adults and geriatrics residing in Sk ...
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Health Medical Director
3 weeks ago
Trinity Health Boise, ID, United States Full timeSaint Alphonsus Medical Group (SAMG) has an excellent full-time employment opportunity for a Board Certified or Board Eligible Psychiatrist to lead a growing group in Boise, Idaho. · Saint Alphonsus is a principal provider of evidence-based, interdisciplinary behavioral health se ...
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Idaho State Job Bank Boise, United StatesExecutive Medical Director, Global Pathology Solutions (Remote) at Danaher Corporation in Boise, Idaho, United States Job Description Leica Biosystems' mission of 'Advancing Cancer Diagnostics, Improving Lives' is at the heart of our corporate culture. We're a global leader in ca ...
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Behavioral Health Medical Director
4 weeks ago
Idaho State Job Bank Boise, United StatesBehavioral Health Medical Director - Southwest Medicaid at Humana in Boise, Idaho, United States Job Description Become a part of our caring community and help us put health first The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operat ...
Associate Medical Director or Medical Director - Boise, United States - Idaho State Job Bank
Description
Associate Medical Director or Medical DirectorGeneral Functions and Outcomes May Include:
Provides clinical leadership for staff to ensure members receive safe, effective and cost efficient services. Contributes to the development of various medical management strategies and tactics to drive results and achieve key performance metrics. Conducts peer clinical review for medical necessity on utilization management authorization requests. Provides clinical input on case management reviews working closely with the CM clinical staff. Responsible for discussing review determinations with providers who request peer-to-peer conversations.
Participates on multiple teams to provide clinical input on medical policy reviews and development and may participate on committees that develop programs impacting clinical interventions, utilization management and case management.
Analyzes and uses data to guide the development and implementation of health care interventions that improve value to the member and employer.
Advises Health Care Services Leaders on related key performance metrics and the effectiveness of various efforts, initiatives, policies and procedures.
Identifies and communicates new opportunities in utilization management, provider contracting or other areas that would enhance outcomes and the reputation of the organization.
Provides clinical expertise and coordinates between internal clinical programs and providers of care to improve the quality and cost of care delivered to health plan members.
Ensures ethical decision making in compliance with contractual arrangements, regulations and legislation. Supports internal communication or training that ensures service is provided to members and providers by a well-trained staff. Promotes provider understanding of utilization management and quality improvement policies, procedures and standards. Provides guidance and oversight for clinical operational and clinical decision-making aspects of the program.Has periodic consultation with practitioners in the field and ensures that the organization has qualified clinicians accountable for decisions affecting consumers.
May manage staff including hiring, performance management, development and retention. May participate in health plan credentialing operations and clinical aspects of the credentialing program and provider services support.Minimum Requirements Demonstrated competency working with hospitals, provider groups or integrated delivery systems to effectively manage patient care to improve outcomes.
Strong communication and facilitation skills with internal staff and external stakeholders, including the ability to resolve issues and seek optimal outcomes.
Proven ability to develop and maintain positive working relationships with community and provider partners.Knowledge of the health insurance industry, state and federal regulations, provider reimbursement methods and evolving accountable care and payment models.
General business acumen including understanding of market dynamics, financial/budget management, data analysis and decision making. Strong orientation to the application of data in managing health and quality.Proven ability to develop creative strategies to accomplish goals and objectives, plan and execute complex projects and programs and drive results across internal teams and/or external partners.
Demonstrated ability to effectively lead and engage in a constructive manner with others.N o rmally to be proficient in the competencies listed above Associate Medical Director would have a MD or DO degree, at least 3 years clinical experience, or equivalent combination of education and experience.
Medical Director would have a MD or DO degree, at least 5 years clinical experience, plus at least 2 years medical utilization management and/or case management experience (prefer health insurance experience and additional MHA or MBA training), or an equivalent combination of education and experience.
Required Licenses, Certifications, Registration, Etc. Licensed Physician with an MD or DO degree.Active, unrestricted license to practice medicine in one or more states or territories of the United States, With one of these licenses in our four-state area (OR, WA, ID, UT).
Applicant must also live in four state area. Board Certification required. Qualification by training and experience to render clinical opinions about medical conditions, procedures and treatments under review. Work Environment Work is performed primarily in an office location. Periodic travel to a different office location, provider office, or other meeting location. May be required to work outside normal working hours. Must be located in a state or territory of the United States when conducting a peer clinical review.#LI-Remote The expected hiring range for an Associate Medical Director is $208,500 - $282,500 and for a Medical Director is $229,000 - $310,000 depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location.
The bonus target for an Associate Medical Director is 25% and for a Medical Director is 30%.The current full salary range for this role is $196,000 - $319,500 for an Associate Medical Director, and is $215,500 - $350,500 for a Medical Director.
Base pay is just part of the compensation package at Cambia that is supplemented with an exceptional 401(k) match, bonus opportunity and other benefits.
In keeping with our Cause and vision, we offer comprehensive well-being programs and benefits, which we periodically update to stay current.
Some highlights:
medical, dental, and vision coverage for employees and their eligible family members annual employer contribution to a health savings account ($1,200 or $2,500 depending on medical coverage, prorated based on hire date) paid time off varying by role and tenure in addition to 10 company holidays up to a 6% company match on employee 401k contributions, with a potential discretionary contribution based on company performance (no vesting period) up to 12 weeks of paid parental time off (eligible day one of employment if within first 12 months following birth or adoption) one-time furniture and equipment allowance for employees working from home up to $225 in Amazon gift cards for participating in various well-being activities.
for a complete list see our External Total Rewards page. We are an Equal Opportunity and Affirmative Action employer dedicated to workforce diversity and a drug and tobacco-free workplace.All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law.
A background check is required.If you need accommodation for any part of the application process because of a medical condition or disability, please email .
Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.As a health care company, we are committed to the health of our communities and employees during the COVID-19 pandemic.
Please review the policy on our Careers site. To view full details and how to apply, please login or create a Job Seeker account
Associate Medical Director or Medical Director professionals in Boise
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