-
Associate Medical Director
3 weeks ago
CommuniCare Family of Companies Union, United States Full timeAssociate Medical Director · The CommuniCare Family of Companies currently owns/operates more than 85 Nursing and Rehabilitation Centers, Specialty Care Centers and Assisted Living Communities in 7 states. Since 1984, CommuniCare Health Services has provided superior, comprehens ...
-
MEDICAL DIRECTOR
3 weeks ago
City of Cincinnati, OH Union, United StatesThis employee provides medical supervision and overall regulation of all medical facets of the City of Cincinnati and within the Health Department. Employee performs the chief medical officer function for the City of Cincinnati's Primary Care program Medical Director, Medical, Di ...
-
Associate Medical Director
1 week ago
CommuniCare Advantage Cincinnati, United States**Associate Medical Director** · The CommuniCare Family of Companies currently owns/operates more than 85 Nursing and Rehabilitation Centers, Specialty Care Centers and Assisted Living Communities in 7 states. Since 1984, CommuniCare Health Services has provided superior, compreh ...
-
Physician Clinic Medical Director
2 days ago
Concentra Erlanger, United States*Up to $30k Sign on Bonus* · As a *Physician Clinic Medical Director* at Concentra, you'll spearhead a committed team of clinicians, guaranteeing smooth center operations and delivering unparalleled patient care. Our Medical Directors at Concentra are adept at balancing patient c ...
-
MEDICAL DIRECTOR
3 weeks ago
City of Cincinnati Cincinnati, United StatesMEDICAL DIRECTOR (Unclassified) Print ) Apply?MEDICAL DIRECTOR (Unclassified)Salary $167, $237,541.89 AnnuallyLocation Ohio 45202, OHJob TypeFull-time UnclassifiedJob Number DepartmentHealthOpening Date04/30/2024Closing Date5/14/2024 11:59 PM Eastern+ Description+ Benefits+ Quest ...
-
MEDICAL DIRECTOR
3 weeks ago
City of Cincinnati Cincinnati, United StatesMEDICAL DIRECTOR (Unclassified) · Print ) · Apply · ? · MEDICAL DIRECTOR (Unclassified) · Salary · $167, $237,541.89 Annually · Location · Ohio 45202, OH · Job Type · Full-time Unclassified · Job Number · Department · Health · Opening Date · 04/30/2024 · Closing D ...
-
MEDICAL DIRECTOR
3 weeks ago
City of Cincinnati, OH Cincinnati, United StatesGeneral Statement of Duties · This employee provides medical supervision and overall regulation of all medical facets of the City of Cincinnati and within the Health Department. Employee performs the chief medical officer function for the City of Cincinnati's Primary Care program ...
-
The Curare Group Union, United StatesThis organization is looking for a member for their Hospitalist program. Located just five miles outside of Cincinnati, you will find affordable housing, great schools, and more. Enjoy all of the benefits of a major metro without the headache of a commute through the city This is ...
-
Director of Medical Services
3 weeks ago
Glenwood Behavioral Health Hospital Cincinnati, United StatesThe Glenwood Behavioral Healthcare Hospital in Cincinnati is Seeking an internal Medicine team two handle 1 to 14 admissions per day for sick leave, sick call emergency room admissions and other medical emergencies. This Physician reports to the CEO and the medical director can b ...
-
Clinic Medical Director
1 week ago
NurseRecruiter, LLC Erlanger, United StatesJob Description · Job DescriptionAs a Clinic Medical Director, you will be a key leader in a dedicated team of clinicians committed to delivering exceptional patient care. You will facilitate efficient center operations by balancing patient care and leadership responsibilities. T ...
-
Community Medical Director
3 weeks ago
The National Coalition of Healthcare Recruiters Cincinnati, United States(Physician/MD qualifications required) · Internal Medicine - MDstaffers is seeking a qualified Community Medical Director in Cincinnati, OH. For more information, please apply or call STAFF. · Job Description · The primary focus of the Medical Director is to oversee and collab ...
-
Oncology Medical Director
2 weeks ago
FCS, Inc. Cincinnati, OH, United States Full timeBoard Certified Psychiatrist needed to serve as Medical Director Adult & Geriatric Inpatient work. Part time to full time. Incredible full time salary range. Full benefits including health, dental, retirement, CME, cell phone, laptop, etc Possible sign on bonus if full-time ...
-
Psychiatrist - Medical Director
4 weeks ago
Medpace Cincinnati, OH, United StatesJob Summary · We are seeking a Psychiatrist - Medical Director to join our dynamic team. The Medical Director will have overall responsibility for providing medical, scientific, and strategic leadership for the successful planning, execution, and reporting of clinical trials. Ad ...
-
Psychiatric Medical Director
2 weeks ago
FCS, Inc. Kentucky, United StatesThis Community Mental Health facility is looking to hire a medical director. You will serve the region and work with a team of Nurse Practitioners. · Requirements: · Active, unencumbered medical license · Psychiatrist License · Clean license history · 5 years of direct clini ...
-
Physician Medical Director MD o DO
2 weeks ago
RELODE Erlanger, United StatesJob Description · Job DescriptionBenefits:401(k) matching · Bonus based on performance · Competitive salary · Dental insurance · Health insurance · Paid time off · Training & development · Vision insurance · About: · With more than 30 years of experience and national recognition ...
-
Physician Center Medical Director
2 weeks ago
Concentra Erlanger, United StatesOverview · Are you ready to take your career to new heights in Northern Kentucky? At Concentra, you will be a vital member of our patient care team and play a crucial role in providing exceptional care to our patients. Our mission is to improve the health of America's workforce, ...
-
Medical Director
1 week ago
Elevance Health Cincinnati, United StatesHealth Solutions is focused on ensuring Elevance Health consumers have access to the highest quality, most affordable care possible. The team is responsible for driving strategic cost of care initiatives that deliver greater value, developing and advancing Elevance Health's clini ...
-
Medical Director
2 weeks ago
VITAS Healthcare Cincinnati, OH, United StatesThe Medical director shall be a physician licensed to practice medicine in the state where the hospice is located. In his/her absence, the medical director shall designate another physician to serve as acting medical director. · The Medical director of VITAS fulfills two primary ...
-
Physician Center Medical Director
3 weeks ago
Concentra Erlanger, KY, United States Full timeAre you ready to take your career to new heights in Northern Kentucky? At Concentra, you will be a vital member of our patient care team and play a crucial role in providing exceptional care to our patients. Our mission is to improve the health of America's workforce, one patient ...
-
Physician Center Medical Director
3 weeks ago
Concentra Erlanger, KY, United States Full timeAt Concentra, you will be a vital member of our patient care team and play a crucial role in providing exceptional care to our patients. Our mission is to improve the health of America's workforce, one patient at a time. The Center Medical Director ensures consistency of clinical ...
Associate Medical Director - Union, United States - CommuniCare Family of Companies
Description
Associate Medical DirectorThe CommuniCare Family of Companies currently owns/operates more than 85 Nursing and Rehabilitation Centers, Specialty Care Centers and Assisted Living Communities in 7 states.
Since 1984, CommuniCare Health Services has provided superior, comprehensive management services for the development and management of adult living communities.
Due to growth, we are seeking an experienced Associate Medical Director.The position of part-time Associate Medical Director is responsible for supporting the Medicare Advantage Plans clinical and quality activities and operations at the direction of the Chief Medical Officer approximately 25 hours per week.
This position reports directly to the Chief Medical Officer, Medicare Advantage Plans.Job duties & responsibilities may include the following and will be finalized based on the skills and interests of the successful candidate:
Medical ManagementSupport strategies and interventions to improve quality outcomes, medical expense trends, and STARS ratingsHealth Care Services ManagementConduct prior authorization and utilization management activities including adverse determinations.
Collaborate with consultant physicians as necessary to review selected authorization requests or appeals of adverse determinations.Support processes relating to performance and audit of vendors or provider organizations delegated for UM.Lead review and submission of clinical practice guidelines, utilization and concurrent review criteria, and other similar guidelines to Medical Policy or applicable committees.
Participate in Plan committees such as Medical Policy, Credentialing, Quality Improvement, Peer Review and others as assigned.Collaborate with medical directors and other clinical leaders from across the contracted network including CHS affiliates as on assigned projects .
Support care innovations across the enterpriseSupport the implementation and execution of the Quality Assurance Plan including but not limited to:Models of CareSTARS and clinical qualityMember and provider satisfactionProvider network accessibility, availability and qualifications]Grievance and AppealsSupport the development and implementation of the Models of Care across the health plan, the CHS Family of Companies and network of providers.
Plan Pharmacy OperationsParticipate in various pharmacy related meetings or activities as assigned.Support processes related to pharmacy appeals process including appeals of adverse determinations.
Regulatory and ComplianceAssure consistent, high quality execution on HIPAA, Privacy, Program Integrity and Fraud, Waste and Abuse protections and activitiesComplete annual Plan compliance training, IRR, and other compliance-related activities.
Assure adherence to documentation and requirements as set forth in the Model of Care for each MA SNP planAssure adherence to regulatory requirements regarding Quality Committees including Quality Improvement, Credentialing, Medical Policy, Peer Review, Quality of Care committees and related activitiesGrowth and Census SupportPhysician Recruitment:Medical Directors, Specialty Physician Program Directors, Attending PhysiciansAttain and enhance physician and hospital relationships to increase referralsParticipate in data reviews, sharing and initiatives to improve member outcomesLiaison to providers when necessary to solicit participation in the Plan provider network, committees or to address QOC or other issues.
Serve as ambassador to other enterpriseMedical Directors and clinical leadersQualifications & Experience requirementsRequires a degree in medicine from an accredited school, Board Certification, and is licensed to practice in applicable states in which the Plan operates.
Requires at least 15 years of Clinical Experience.Requires 3 to 5 years prior experience as a CMO or Associate Medical Director preferably for a Medicare, MMP, or Medicaid plan inclusive of dually eligible enrollees.
Experience in working in post-acute facilities, assisted living facilities, home and community-based service settings preferred.Geriatric training and experience preferred but not required.
