Job Opportunity: Medical Director $200000 - $220000

Location:Harrisburg, PA
Salary:$200000 - $220000
Job Type:Full Time
Suggested Degree Level: Medical Doctor

General Comments:
Unique opportunity to help make your community healthier and better! Exciting opportunity for a Senior Medical Director based in PA. The Sr. Medical Director supports the Executive Director by providing medical strategic direction, leadership and oversight in the areas of program design and implementation. The Medical Director oversees the ongoing day-to-day management of activities which requires clinical expertise including quality and medical appropriateness of care provided and compliance with State, regulatory and company healthcare guidelines and policies.

Responsibilities:
Establishes relationships and provides medical consultation services and oversight and consultation to clinical staff, providers and/or community
Support the acquisition of new or expanded revenue or business. Identifies highly-visible events within the State at which Program representation will provide exposure and important opportunities to meet with key stakeholders.
Increase participant enrollment in Case Management and Disease Management programs by promoting services to providers and consumers.
Develops and conducts staff or provider education to as needed and to ensure compliance
Manages Quality Improvement staff (QI Manager and QI RN Coordinators) including monitoring performance and developing goals and objectives for staff in accordance with departmental goals and objectives.
Develops performance metrics for clinical and Quality Improvement (QI) staff. Identifies and reports any barriers that impact the success the program.
Conducts provider liaison/education and outreach
Visits 50 High Volume Practice Sites or sites in need of technical assistance related to quality improvement activities, annually, at a minimum.
Chairs and convenes the Clinical Advisory Committee
Participates in management meetings, clinical meetings, operational meetings and/or state meetings as required
Reviews cases, quality of care, adverse outcomes, incident reports, guidelines and staff tools as needed

Credentials Required:
Doctor of Medicine (M.D.) or Doctor of Osteopathic Medicine (D.O.)
Board certification in a primary care field
Active and valid license in the State of Pennsylvania required

Qualifications:
Minimum of 5 years of post-graduate, post-residency clinical experience
Experience with Pennsylvania Medicaid recipients, policies, data systems and processes. Knowledge of unique needs of medically underserved populations.
Experience with disease management programs using the Chronic Care Model
Administrative experience in managed care environment
Experience in disease management, case management and provider relations; utilization review and peer review preferred
Experience in program development and implementation
Experience in quality improvement methodology
Knowledge of disease management, case management, quality improvement, utilization review, and related data interpretation
Knowledge of clinical diagnosis and management of disease processes and chronic illnesses
Strong negotiation, management and leadership skills. Excellent presentation skills to diverse audiences. Excellent skills in developing business correspondences, strategic plans and program impact reports
Able to work effectively with an interdisciplinary management team
Ability to evaluate patient cases from nursing assessments/interventions and claims data to recommend appropriate levels of care
Ability to use financial and clinical data to develop intervention strategies on the population level
Evaluate organizational performance data to design program modifications