Jobs
>
Philadelphia

    Medical Director - Philadelphia, United States - Blue Cross and Blue Shield Association

    Blue Cross and Blue Shield Association
    Blue Cross and Blue Shield Association Philadelphia, United States

    18 hours ago

    Default job background
    Description
    At Independence, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect.

    We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace.

    Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.


    The Medical Director serves as a physician leader responsible for promoting the delivery of safe and effective medical care in the most cost effective way for the health plans offered by Independence Blue Cross and subsidiaries.

    There are multiple elements of discrete work that may fall under the role including:

    Utilization Management


    The physician directly supports Utilization Management and Care Management and other business activities where involvement of a physician is determined to be in the best interest of Independence.

    The Medical Director will be responsible for rendering coverage and payment determinations based on the terms and conditions of the health plans for which Independence serves as claims administrator, and on the terms and conditions of contracts executed between Independence and networks of participating health care providers.


    The Medical Director will exercise sound decision making based on clinical guidelines for best practices, a strong knowledge of clinical medicine, the practical realities of the delivery of health care in the state of Pennsylvania, and a thorough understanding of the principles of population health, quality management, patient safety and health insurance.

    The Medical Director will be expected to effectively collaborate with professional staff, senior leadership, management and associates and with external partners to promote the delivery of cost-effective health care across all lines of business.


    Required Qualifications and Experience:

    • We require a Medical Doctor or Doctor of Osteopathy degree from a medical school or osteopathic medical school recognized by the American Association of Medical Colleges (AAMC), the American Osteopathic Association (AOA), or the World Health Organization (WHO).
    • Has an unrestricted and unencumbered Pennsylvania or New Jersey licenses to practice clinical medicine or osteopathic medicine.
    • Current Board Certification by ABMS or AOBMS - family medicine board certification preferred
    • Ability to successfully complete Independence Blue Cross credentialing process

    Fully Remote:
    This role is designated by Independence as fully remote. The incumbent will not be required to report to one of Independence's physical office locations to perform the work. However, the work must be performed in the Tri-State Area of Delaware, New Jersey, or Pennsylvania.

  • Mazzoni Center

    Medical Director

    18 hours ago

    Mazzoni Center Philadelphia, United States

    Job Summary: The position of "Medical Director" is responsible for the coordination and oversight of all medical care provided at Mazzoni Center and for the quality of services rendered. The Medical Director will report to the Executive Medical Officer and will ensure proper func ...

  • Integrity Healthcare

    Medical Director

    5 days ago

    Integrity Healthcare Philadelphia, United States

    Remote Opportunity: Primarily this position is remote from the providers home. Once a week may be expected to conduct team meetings from an office space and possibly see patients in the patients home once in a while. - The Medical Director will not Medical Director, Director, Med ...

  • Public Health Management Corporation

    Medical Director

    18 hours ago

    Public Health Management Corporation Philadelphia, United States

    PHMC is proud to be a leader in public health. PHMC requires all employees to be fully vaccinated for COVID-19 before the first day of employment. We will offer the vaccination at no cost via our Health Centers. · LEAD IN A DYNAMIC AND GROWING HEALTH CENTER NETWORK SERVING ACROSS ...

  • Community Behavioral Health.

    Director, Medical Director

    2 weeks ago

    Community Behavioral Health. Philadelphia, PA, United States

    Job Description The Medical Director of Adult Services is responsible for providing administrative oversight and supervision of the CBH physician advisors conducting utilization review for our adult members. The position provides leadership in the development and implementation o ...

  • Calcium+Company

    Medical Director

    5 days ago

    Calcium+Company Philadelphia, United States

    Job Description · Job DescriptionJOB DESCRIPTION · MEDICAL DIRECTOR · Vitamin MD · Reports to: EVP, Medical Director · Job Summary · The Medical Director is a core member of the Medical team at Vitamin MD and will be responsible for providing sound scientific support and directi ...

  • Mazzoni Center

    Medical Director

    1 week ago

    Mazzoni Center Philadelphia, United States

    Job Description · Job DescriptionJob Summary: The position of "Medical Director" is responsible for the coordination and oversight of all medical care provided at Mazzoni Center and for the quality of services rendered. The Medical Director will report to the Executive Medical Of ...

  • Children's Hospital of Philadelphia

    Medical Director

    2 weeks ago

    Children's Hospital of Philadelphia Philadelphia, United States

    SHIFT: · Day (United States of America) Seeking Breakthrough Makers · Children's Hospital of Philadelphia (CHOP) offers countless ways to change lives. Our diverse community of more than 20,000 Breakthrough Makers will inspire you to pursue passions, develop expertise, and driv ...

  • Intercommunity Action I

    medical director

    6 days ago

    Intercommunity Action I Philadelphia, United States

    Job Description · Job DescriptionPosition Type: Part Time/Full TimePURPOSE: · The Medical Director is responsible for psychiatric oversight supporting outpatient clinical operations. They will work in a community mental health outpatient setting, delivering compassionate, trauma ...

  • ProgenyHealth, LLC

    Medical Director

    2 weeks ago

    ProgenyHealth, LLC Philadelphia, PA, United States

    ProgenyHealth empowers our health plan and employer partners to change the trajectory of maternal and infant health outcomes across America. Informed by more than 20 years of experience and patient data, our end-to-end maternal and infant care management solution helps ensure the ...

  • Children's Hospital of Philadelphia

    Medical Director

    2 weeks ago

    Children's Hospital of Philadelphia Philadelphia, United States

    SHIFT: · Day (United States of America) Seeking Breakthrough Makers · Children's Hospital of Philadelphia (CHOP) offers countless ways to change lives. Our diverse community of more than 20,000 Breakthrough Makers will inspire you to pursue passions, develop expertise, and driv ...

  • Mazzoni Center

    Medical Director

    3 weeks ago

    Mazzoni Center Philadelphia, PA, United States

    Job Description · Job Description · Job Summary: The position of "Medical Director" is responsible for the coordination and oversight of all medical care provided at Mazzoni Center and for the quality of services rendered. The Medical Director will report to the Executive Medi ...

  • Provider Healthcare

    Medical Director

    4 days ago

    Provider Healthcare Philadelphia, PA, United States

    PACE facility seeks a medical director for a full time, permanent position. Responsible for oversight of day-to-day medical operations at the center and provide supervision of physicians and adult NP. 65% of position will be primary care work and 35% will be administrative and su ...

  • Intercommunity Action I

    Medical Director

    2 weeks ago

    Intercommunity Action I Philadelphia, PA, United States

    Job Description · Job Description Position Type: Part Time/Full Time PURPOSE: · The Medical Director is responsible for psychiatric oversight supporting outpatient clinical operations. They will work in a community mental health outpatient setting, delivering compassionate, tra ...

  • Cabaletta Bio

    Medical Director/Senior Medical Director, Medical Affairs

    18 hours ago

    Cabaletta Bio Philadelphia, United States

    Medical Director/Senior Medical Director, Medical Affairs · Philadelphia, PA · About the Position · Reporting to the Vice President, Medical Affairs, we are seeking a highly motivated and experienced Medical Director/Senior Medical Director to join our Medical Affairs team. The i ...

  • PATH People Acting To Help, Inc.

    Medical Director

    1 week ago

    PATH People Acting To Help, Inc. Philadelphia, United States

    Job Description · Job DescriptionABOUT PATH INC. · PATH (People Acting to Help) Inc. is a comprehensive Community Behavioral Health and Intellectual Disability Center. We offer a wide of array of services and supports to meet the needs of our community in Northeast Philadelphia. ...

  • Quantum Innovations

    Medical Director

    1 week ago

    Quantum Innovations Lionville, United States

    There are many reasons to collaborate with European Medical Consulting Adam. In the following section, you will see how you can benefit from our free services and save valuable time: · You will be informed about exclusive and unpublished job opportunities · Our relocation service ...

  • PATH People Acting To Help, Inc.

    Medical Director

    3 weeks ago

    PATH People Acting To Help, Inc. Philadelphia, PA, United States

    Job Description · Job Description · ABOUT PATH INC. · PATH (People Acting to Help) Inc. is a comprehensive Community Behavioral Health and Intellectual Disability Center. We offer a wide of array of services and supports to meet the needs of our community in Northeast Philadel ...

  • Omega Dynamics

    Medical Director

    1 week ago

    Omega Dynamics Schwenksville, United States

    As a renowned consulting firm, we specialize in the placement of specialized and executive personnel exclusively in the medical field. Our consultants and recruiters have extensive experience and a wide network of decision-makers in the medical sector. Our clients include well-kn ...

  • Advanced MedAesthetic Partners Inc

    Medical Director

    2 weeks ago

    Advanced MedAesthetic Partners Inc Cooper City, United States

    Job Description · Job Description Description: · Elevate your career at · The Aesthetic Clinique , where we pioneer groundbreaking techniques for a natural aesthetic appearance. Committed to the highest standards of expertise, safety, and customer service, we are dedicated to ...

  • Advanced MedAesthetic Partners, Inc.

    Medical Director

    3 days ago

    Advanced MedAesthetic Partners, Inc. Cooper City, United States

    Job Type · Full-time · Description · Elevate your career at · The Aesthetic Clinique , where we pioneer groundbreaking techniques for a natural aesthetic appearance. Committed to the highest standards of expertise, safety, and customer service, we are dedicated to delivering ...