Medical Director - Quality & Utilization Lead

Arizona Complete Health; Arizona; Hybrid; USD 226,000 - 429,000; Full time

Benefits offered by this job

Health insurance

401K and stock plans

Tuition reimbursement

Paid time off

Flexible work arrangements

Job summary

Arizona Complete Health in the United States seeks a Board-Certified Physician to assist the Chief Medical Director in directing and coordinating medical management, quality improvement and credentialing across the business unit.

This physician-leader will oversee utilization management, medical review, performance improvement initiatives, provider network collaboration, and regulatory/ accreditation compliance.

Qualifications

• MD or DO with medical licensure and board certification.
• Utilization management experience and quality accreditation knowledge.
• Active practice of medicine and leadership in clinical settings.

Responsibilities

• Provide medical leadership for utilization management, cost containment and quality improvement.
• Perform medical reviews for utilization, quality assurance and complex cases.
• Support performance improvement initiatives for capitated providers.
• Develop goals and policies to improve quality and cost-effectiveness of care.
• Offer medical expertise in quality improvement and utilization programs in line with regulatory requirements.
• Assist in physician committee functioning and processes.

Skills

Utilization management

Quality improvement

Medical review

Clinical leadership

Provider collaboration

Education

MD or DO degree

Board certification

Arizona medical license

Job description

Arizona Complete Health in the United States seeks a Board-Certified Physician to assist the Chief Medical Director in directing and coordinating medical management, quality improvement and credentialing across the business unit.

This physician-leader will oversee utilization management, medical review, performance improvement initiatives, provider network collaboration, and regulatory/ accreditation compliance.