Maryland Primary Care Physicians logo
Maryland Primary Care Physicians

Healthcare that feels personal, because it is. Celebrating 30 years of physician-owned, trusted care in Central Maryland

Medical Director

Medical DirectorMedical DirectorFull TimeRemoteLeadTeam 201-500Since 1996Company SiteLinkedIn

Location

Maryland

Posted

20 hours ago

Salary

$266K - $315K / year

Seniority

Lead

Postgraduate Degree5 yrs expEnglish

Job Description

• Under the direction of the Senior Medical Director, lead and participate in the Medical Management Program • Assist in the development and implementation of comprehensive medical policies and standards of care • Provide leadership for the Health Management Teams • Responsible for the general supervision of Utilization Management, Quality Management and Inpatient Concurrent Review • Conduct peer-to-peer clinical case reviews with attending physicians, physician advisors or other ordering providers to discuss review determinations • Identify and report quality of care issues • Participate in MPC/MCO Grievance and Appeals Review Processes • Participate in the QM/UM Committee, the Pharmacy and Therapeutics Committee, and the Credentialing Committee as needed

Job Requirements

  • M.D. or D.O. unincumbered license with a minimum of five (5) years of post-residency clinical experience
  • Active Board certification
  • Experience in managed care practices, processes, procedures, and operations
  • Experience in utilization review and management practices, processes, and procedures
  • Knowledge and familiarity with contracts and policies as they pertain to the managed care environment
  • Knowledge and familiarity of local, regional, and national provider medical standards of care
  • Ability to establish and maintain constructive relationships with diverse members, management, employees, and vendors
  • Ability to successfully utilize Microsoft Office Suite software applications and common computer and office hardware
  • Knowledge of Medicaid and Commercial regulatory requirements is beneficial.

Benefits

  • medical, dental, and vision plans
  • 100% employer Term Life Insurance
  • Short and Long-Term Disability
  • 401k Employer Match up to 4%
  • 20 days of PTO
  • tuition assistance/professional development plans

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