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Administrative Physician - Physicians Only Apply - Perm

Company: Catherine Stenberg
Location: Saint Louis
Posted on: June 7, 2024

Job Description:

A Administrative Physician practice is seeking a qualified physician for St. Louis, MO. This and other physician jobs brought to you by ExactMD. Medical Doctors Only Apply.

Senior Medical Director
This job will have the following responsibilities:

  • Lead, develop, direct and implement clinical and non-clinical activities that impact health care quality, cost and outcomes.--
  • Direct the utilization review process and oversee the quality of utilization determinations.--

  • Be responsible for overall medical policies of the unit to ensure the appropriate and most cost effective medical care is received.--Recommend changes and enhancements to current managed care, review guidelines, and clinical criteria .
  • Develop, implement, and interpret medical--polices.--
  • Lead clinical staff in the coordination of quality care.

  • Provide clinical expertise and business direction in support of medical management programs through participation in clinical team activities.

  • Act as lead business and clinical liaison to network providers and facilities to support the effective execution of medical services programs by the clinical teams.

  • Responsibility for predetermination reviews ad reviews of claim determinations, providing clinical, coding, and--reimbursement expertise.

  • Expand--their medical management programs to address member needs across the continuum of care.

    Qualifications & Requirements:

    • 3 to 5 + years of--experience in the health care delivery system with 3-5 years additional leadership and management experience in the health care industry.
    • Active unrestricted--MD or DO license is required.

    • Specialty in Primary Medicine or Internal Medicine preferred.
    • Prior Managed Care experience

    • Active unrestricted Board Certification is required. Must be board certified, not board "eligible"

Keywords: Catherine Stenberg, St. Louis , Administrative Physician - Physicians Only Apply - Perm, Healthcare , Saint Louis, Missouri

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