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    Medical Director, Medicaid Florida - Jacksonville, United States - Sentara

    Sentara
    Sentara Jacksonville, United States

    3 weeks ago

    Default job background
    Description
    City/State
    Tallahassee, FL

    Overview
    Work Shift
    First (Days) (United States of America)

    Sentara Health

    is seeking to hire a qualified individual to join our team as a
    Medical Director, Medicare.
    Position Status

    :

    Full-time. Possible opportunity for flexible work schedule (Hybrid).

    Position Location:

    This position is an onsite position for the Virginia Beach area of VA.
    Position Summary

    :

    Responsible for providing clinical leadership within Sentara Health Plans, aligned to one or more plans. Accountable for monitoring utilization, case management and quality outcomes.

    The Medical Director collaborates with the Sentara Health Plans Chief Medical Director, Senior Medical Director(s) and Clinical Care Services (CCS) teams to establish, implement, and evaluate effectiveness of clinical programs to support members and meet the department goals.

    Medical Director activities further include support of the CCS nurses, Government services nurses, Pharmacy staff, Population Health and Quality Improvement Teams.

    Lastly, Medical Directors interact externally with network physicians, vended program clinical leaders, and government program leaders as required to improve the quality of clinical outcomes, cost efficiency and patient/member experience with the Health Plan and Health Systems with which we contract.


    Minimum Requirements:
    Licensed in the state of health plan coverage and board certification

    Master's level degree

    Five years or more of related experience


    Preferred:
    Medicaid, including long term services and support, and/or Medicare, including D-SNP

    Degree in

    Medical Management, Business Administration or Public Health

    Sentara Health Plans


    is the health insurance division of Sentara Health that provides health insurance coverage through a full suite of commercial products including consumer-driven, employee-owned and employer-sponsored plans, individual and family health plans, employee assistance plans and plans serving Medicare and Medicaid enrollees.

    With more than 30 years' experience in the insurance business and 20 years' experience serving Medicaid populations, we offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services - all to help our members improve their health.

    Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth.

    Diversity and Inclusion at Sentara
    Our vision is that everyone brings the strengths that come with diversity to work with them every day.

    When we are achieving our vision, we have team members that feel they belong and can be their authentic selves, and our workforce is reflective of the communities we serve.

    We are realizing this vision through our Diversity and Inclusion strategy, which has three pillars:

    A diverse and talented workforce, an inclusive and supportive workplace, and outreach and engagement with our community.

    We have made remarkable strides in these areas over the past several years and, as our world continues to evolve, we know our work is never done.

    Our strategies focus on both

    structural inclusion

    , which looks at our organizational structures, processes, and practices; as well as

    behavioral inclusion

    , which evaluates our mindsets, skillsets, and relationships. Together, these strategies are moving our organization forward in an environment that fosters a culture of mutual respect and belonging for all.
    Sentara Benefits

    As the third-largest employer in Virginia, Sentara Health was named by Forbes Magazine as one of America's best large employers.

    We offer a variety of amenities to our employees, including, but not limited to:

    Medical, Dental, and Vision Insurance

    Paid Annual Leave, Sick Leave

    Flexible Spending Accounts

    Retirement funds with matching contribution

    Supplemental insurance policies, including legal, Life Insurance and AD&D among others

    Work Perks program including discounted movie and theme park tickets among other great deals

    Opportunities for further advancement within our organization

    Sentara employees strive to make our communities healthier places to live. We're setting the standard for medical excellence within avibrant, creative, and highly productive workplace.

    For information about our employee benefits, please visit:
    Benefits - Sentara )

    Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve
    To apply, please go to

    and use the following as your Keyword Search:

    JR-37261.
    #Indeed
    #Monster
    #LI-LR1
    Talroo - Health Plan
    Managed Care, Health Plan, Healthcare, Medical Director
    Please Note:

    The Covid Vaccination(s) and yearly Flu Vaccination are required for employment.
    Note:

    Sentara Healthcare offers employees comprehensive health care and retirement benefits designed with you and your family's well-beingin mind. Ourbenefits packages are designed to change with you by meeting yourneeds now and anticipating what comes next.

    You have a variety of options for medical, dental and vision insurance, life insurance, disability, and voluntary benefits as well as Paid Time Off in the form of sick time, vacation time and paid parental leave.

    Team Members have the opportunity to earn an annual flat amount Bonus payment if established system and employee eligibility criteria is met.

    Job Summary
    The Medical Director is responsible for providing clinical leadership within Sentara Health Plans, aligned to one or more plans. Accountable for monitoring utilization, case management and quality outcomes.

    The Medical Director collaborates with the Sentara Health Plans Chief Medical Director, Senior Medical Director(s) and Clinical Care Services (CCS) teams to establish, implement, and evaluate effectiveness of clinical programs to support members and meet the department goals.

    Medical Director activities further include support of the CCS nurses, Government services nurses, Pharmacy staff, Population Health and Quality Improvement Teams.

    Lastly, Medical Directors interact externally with network physicians, vended program clinical leaders, and government program leaders as required to improve the quality of clinical outcomes, cost efficiency and patient/member experience with the Health Plan and Health Systems with which we contract.

    Licensed in the state of health plan coverage and board certification required. Master's level degree in Medical Management, Business Administration or Public Health preferred. Medicaid, including long term services and support, and/or Medicare, including D-SNP, experience preferred


    Qualifications:
    MD - Doctor of Medicine

    (Required)Medical Doctor (MD) - Certification - North Carolina, Medical Doctor (MD) - Certification - Other/National, Medical Doctor (MD) - State License - Virginia Department of Health Professionals (VADHP)Clinical Practice, Performance Improvement, Population Management, Project Management

    Skills

    Active Learning, Active Learning, Active Listening, Communication, Complex Problem Solving, Coordination, Critical Thinking, Judgment and Decision Making, Leadership, Learning Strategies, Mathematics, Mgmt of Financial Resources, Mgmt of Material Resources, Mgmt of Staff Resources, Microsoft Excel, Microsoft Word, Monitoring, Persuasion, Project Management, Quality Control Analysis, Reading Comprehension, Science, Service Orientation, Social Perceptiveness, Speaking {+ 5 more} Sentara Healthcare prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce.

    Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.

    Per Clinical Laboratory Improvement Amendments (CLIA), some clinical environments require proof of education; these regulations are posted at for further information.

    In an effort to expedite this verification requirement, we encourage you to upload your diploma or transcript at time of application.

    In support of our mission "to improve health every day," this is a tobacco-free environment.

    #J-18808-Ljbffr
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