Medical Director Health Plans - Part Time
Christus Health
Job Info
Summary:
The Director - Medical Director, Health Plans is responsible for the direction and oversight in appropriateness and medical necessity of health services, and all aspects of utilization management, case management, disease management. In carrying the responsibilities of this position, the Medical Director works closely with the Health Plan Directors and Health Plan Associates. The Medical Director coordinates activities with the Health Plan Directors and the Vice President, Chief Medical Director, Quality Performance, & Innovation of the Population Health and Health Plans. The Medical Director has consultations with practitioners in the field as required in order to perform the duties of the position. The Medical Director ensures through his role and functions to provide improvement in member and provider satisfaction.
Requirements:
- Graduate of an accredited Medical School.
- Board Certification in area of specialty, preferably Primary Care
- Current unrestricted license to practice medicine in the state of Texas.
- Minimum 5 years of experience in Clinical Practice.
- Minimum 2 years Managed Care and Care Management experience
- Experienced in coordinating physicians in both community and academic medical centers preferred.
- Knowledge of NCQA, HEDIS, Medicaid, Medicare and Federal programs.
- Knowledge of applicable state, federal and third-party regulations.
- Current and unrestricted Medical licensure in the States where CHP operates. (Texas, New Mexico and LA) or eligible to obtain such licenses.
Part Time
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