Part Time-Associate Medical Director(Required Weekends)

CareSource; United States; Remote; USD 191,000 - 335,000; Part time

Job summary

An established industry player is seeking a Part Time Associate Medical Director to enhance clinical practices and support staff through training and consultation. This role involves engaging in peer discussions, conducting clinical reviews, and ensuring compliance with regulatory standards. The ideal candidate will possess a medical degree, relevant clinical experience, and strong communication skills. This position offers a unique opportunity to impact community health positively while working in a collaborative environment. If you are dedicated to improving healthcare outcomes and thrive in a dynamic setting, this role is for you.

Qualifications

• Completion of an accredited Medical Degree program is required.
• Minimum of five years of clinical practice experience is required.

Responsibilities

• Provide clinical consultation and case review for members.
• Participate in fraud investigations and policy development.

Skills

Excellent communication skills

Decision making/problem solving skills

Attention to detail

Conflict resolution skills

Ability to create strong relationships with Providers and Members

Critical listening and systematic thinking skills

Ability to work well independently and within a team

High ethical standards

Ability to act with diplomacy and sensitivity to cultural diversity

Education

Medical Degree (MD or DO)

Residency training in primary care

Bachelor's or Master's in Business Administration or related field

Tools

Microsoft Word

Job description

Job Summary:

The Part Time Associate Medical Director supports staff by providing training, clinical consultation, and clinical case review for members.

Essential Functions:

• Participate in peer-to-peer discussions
• Provide provider education, training, data sharing, performance evaluations and orientation to the plan
• Participate in the evaluation and investigations of cases suspected of fraud, abuse, and quality of care concerns
• Participate in development of policies and procedures
• Provide cross-coverage for other Medical Directors and/or markets, as needed
• Provide prior authorization medical reviews, consultation and clinical review services
• Conduct clinical reviews for designated CareSource members
• Clinical Appeals
• Support of regulatory and accreditation functions (eg. CMS, State, NCQA and URAC) and compliance for all programs
• Perform any other job related instructions, as requested

Education and Experience:

• Completion of an accredited Medical Degree program as a medical doctor (MD) or Doctor of Osteopathic (DO) medicine is required
• Successful completion of a residency training program, preferably in primary care is required
• Minimum of five (5) years of clinical practice experience is required
• Managed care medical review/medical director experience is preferred
• Bachelor's or Master's degree in Business Administration, Operational Excellence, Healthcare Administration or Medical Management is preferred

Competencies, Knowledge and Skills:

• Basic Microsoft Word skills
• Excellent communication skills, both written and oral
• Ability to work well independently and within a team environment
• Ability to create strong relationships with Providers and Members
• High ethical standards
• Attention to detail
• Critical listening and systematic thinking skills
• Ability to maintain confidentiality and act in the company’s best interest
• Ability to act with diplomacy and sensitivity to cultural diversity
• Decision making/problem solving skills
• Conflict resolution skills
• Strong sense of mission and commitment of time, effort and resources to the betterment of the communities served

Licensure and Certification:

• Current, unrestricted license to practice medicine in state of practice as necessary to meet regulatory requirements is required
• Board Certification, preferably in primary care specialty is required
• Re-certification, as required by specialty board, must be maintained (exceptions may be granted by Chief Medical Officer)
• MCG Certification is required or must be obtained within six (6) months of hire

Working Conditions:

• General office environment; required to use general office equipment
• May be required to work evenings/weekends
• May be required to travel to fulfill duties of position

Compensation Range:

$191,400.00 - $334,900.00

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary): Hourly

Organization Level Competencies:

• Create an Inclusive Environment
• Cultivate Partnerships
• Develop Self and Others
• Drive Execution
• Influence Others
• Pursue Personal Excellence
• Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an inclusive environment that welcomes and supports individuals of all backgrounds.