Medical Director, Select Health, Colorado

61000 SelectHealth Inc; Lone Tree (CO); On-site; USD 220,000 - 250,000; Part time

Benefits offered by this job

Annual leadership incentive

Sign-on bonus

Relocation bonus

Job summary

Select Health in Colorado seeks a part-time Medical Director to provide medical direction and policy guidance within a heavily matrixed business environment. The role reports to the Chief Medical Officer and supports local clinical relationships, product and plan performance, and market understanding.

Ideal candidates will have MD/DO with board certification and licensure in CO, plus at least five years of clinical practice.

Qualifications

• Medical Doctor or Doctor of Osteopathic Medicine with board certification in Internal Medicine, Pediatrics, Family Practice, Psychiatry, or Emergency Medicine.
• MD/DO license in Utah, Idaho, Nevada or Colorado.

Responsibilities

• Reviews physician review operation and provides high-level consultation and medical direction.
• Develops and implements operational policies for contracted benefits.
• Approves medical changes for products/health benefits.
• Coordinates provider credentialing standards and issues.
• Collaborates on paneling and contracting to drive outcomes.

Skills

Leadership communication

Initiative

Performance management

Process improvements

Teamwork

Workflow optimization

Process documentation

Health plan operation

Regulatory knowledge

Computer literacy

Education

MD/DO with Board Certification

Job description

Select Health is a not-for-profit community health plan serving more than one million members in the Intermountain west across multiple states and multiple lines of business. Select Health is seeking a part-time medical director within Colorado. Reporting to the Select Health Chief Medical Officer, this Medical Director role is a part-time local Medical Director with a heavily matrixed accountability to the Select Health Market President to aid in local clinical relationships, product and plan performance and to understand local market specifics.

Essential Functions

• Reviews physician review operation and provides high-level consultation, review and medical direction.
• Provides medical consultation in the development and implementation of operational policies and procedures for the accurate and appropriate administration of contracted benefits.
• Reviews and approves all medical changes and options for all products and/or health benefits.
• Coordinates with the credentialing process including developing standards, evaluating provider credentials, advising others and resolving issues with credentialed and non-credentialed providers.
• Works with others across the organization on the paneling and contracting process to ensure appropriate outcomes.
• Participates in corporate strategic planning with other leaders across the organization and helps facilitate seamless integration by maintaining effective cross-divisional and cross-functional decision-making processes and relationships.
• Works closely and collaboratively with other departments to optimize operational success.
• Coordinates with the Medical Technology review process.
• Willingness to perform physician reviews in addition to overseeing medical reviewers to ensure completeness, timeliness and accuracy.

Skills

• Leadership Communication
• Taking Initiative
• Performance management
• Process Improvements
• Teamwork
• Workflow optimization
• Process documentation
• Health plan operation
• Federal, state and local regulations
• Computer Literacy

Additional Information

FTE: 0.2 / 8 hours per week

Rate: $159.78 to $181.48 per hour based on relevant experience

Eligible for an annual leadership incentive opportunity based on system goals

In addition to the annual salary, to show our commitment to you and assist with your transition, we may offer a sign-on and relocation bonus when applicable.

Minimum Qualifications

• Medical Doctor or Doctor of Osteopathic Medicine degree with Board Certification in one of the following areas: Internal Medicine, Pediatrics, Family Practice, Psychiatry or Emergency Medicine.
• Requires current MD or DO licensure within the State of Utah, Idaho, Nevada or Colorado.
• Five years of experience in clinical practice.

Preferred Qualifications

• Previous management experience.
• Experience with financial and medical expense management.
• Knowledge of managed care products and processes as well as the impact of managed care on the market and cost of health care.
• Understanding of health care delivery system as it relates to government programs and agencies.
• Excellent communication skills including ability to establish and maintain rapport with coworkers, providers, brokers, employers, plan members, representatives/executives from other health care entities, government and regulatory bodies and others in the community.

Physical Requirements

Ongoing need for employees to see and read information, documents, monitors, identify equipment and supplies, and be able to assess member, provider, and coworkers' needs.

Frequent interactions with colleagues and providers require employees to verbally communicate as well as hear and understand spoken information, needs, and issues quickly and accurately.

Frequent computer use for typing, accessing needed information, etc.

Location

Location: SelectHealth - Lone Tree
Work City: Lone Tree
Work State: Colorado
Scheduled Weekly Hours: 40

The hourly range for this position is listed below. Actual hourly rate dependent upon experience.
$70.00 - $999.99

Benefits and Culture

We care about your well-being - mind, body, and spirit - which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged. Learn more about our comprehensive benefits package here.

Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

All positions subject to close without notice.

Thanks for your interest in continuing your career with our team!