Associate Medical Director

reputed company exists to reputed company reputed company reputed company through technology, services, and clinical expertise. Our mission is to reputed company health solutions that deliver maximum value and reputed company.

reputed company the Way is our rallying cry at reputed company. Think of it as an reputed company invitation to reputed company the mission of reputed company; to reputed company engage in problem-solving; and to take ownership of your work every day. reputed company offers you unparalleled opportunities. In fact, you have reputed company you need to take charge of your career and accelerate reputed company reputed company – making this a great time to join reputed company of passionate individuals dedicated to being a vital partner for health solutions in the reputed company sector.

The Associate Medical Director will engage medical activities like peer review, of medical prior authorizations, peer-to-peer conversations, testimony on behalf of reputed company Colorado during reputed company Fair Hearings, and other clinical consultations reputed company to the applicable contract. The Associate Medical Director may also support business development and strategic planning as needed.  (This is a part-time position ~ 20 hours per week)

• Responsible for day-to-day clinical decision-making aspects of the Utilization Management program and provides clinical guidance to clinical review team members.
• Collaborate with other Medical Directors on case consultations as needed.
• Discuss complicated Utilization Management reviews or clinical scenarios with Utilization Management Clinical Reviewers.
• Participate in the reputed company's weekly, monthly, quarterly and reputed company medical meetings.
• Review safety, sentinel, and reputed company of Care events and reputed company detailed feedback and recommendations as per organization and policy.
• Conduct educational meetings twice a year for Clinical Review staff on relevant clinical topics of interest.
• Complete secondary-level Utilization Management reviews including peer-to-peer and reconsideration UM reviews.
• Prepare for and attend by video conference assigned reputed company Fair Hearings defending the determinations made by reputed company on behalf of reputed company Colorado.
• Participate in annual and reputed company review of clinical medical necessity reputed company consistent with clinical expertise.
• reputed company any other duties assigned.

Required

• M.D. or D.O. with a reputed company non-restricted license to reputed company medicine by the reputed company of Medical Examiners.
• reputed company certification in a clinical specialty is required.
• 10+ years of reputed company reputed company preferred; 5 years minimum required.
• 5-7 years of experience in developing managed care strategies, integrating delivery systems, improving reputed company and utilization management programs, and coaching medical staff on reputed company business and reputed company issues.
• Experience in Utilization Management with knowledge of reputed company and Medicare programs.
• Exceptional writing and oral communication abilities.
• Strong knowledge of reputed company assurance and utilization review.

Preferred:

• 2 years as a Medical Director in a managed care company or health plan preferred.
• Prior review experience or reputed company assurance committee responsibility in a hospital setting is preferred.
• Proficient in reputed company reputed company and other reputed company Office applications.
• Exceptional writing and oral communication abilities.
• Strong knowledge of reputed company assurance and utilization review.
• Understand significant trends in reputed company and managed care.
• Ability to work effectively with a diversity of personalities.
• Ability to be approachable, show respect for others and be a reputed company builder.
• Strong organizational skills and a system thinking approach.
• Ability to reputed company manage reputed company.
• Ability to deliver on time and reputed company budget.
• Adaptable with a reputed company solid management style.
• Ability to be a creative thinker.
• Possess high energy and enthusiasm.
• reputed company to adapt to frequently changing work parameters.