Medical Director II, Utilization Management

Job not on LinkedIn

🕒 June 16

🇺🇸 United States – Remote

💵 $280k - $345k / year

⏰ Full Time

🔴 Lead

👨‍⚕️ Medical Director

👻 Ghost score 55%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.Why this score:

• Open for 149 days.
• Jobs at this company usually fill in 23 days.
• Reposted 2 times.

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Devoted Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2017

🏥 Healthcare

⚕️ Healthcare Insurance

🧘 Wellness

Healthcare • Healthcare Insurance • Wellness

Devoted Health is a healthcare company that offers Medicare Advantage plans designed to provide comprehensive health coverage with added benefits like dental, eyewear, gym memberships, and prescription drugs at competitive rates. The company emphasizes member support and service, ensuring that clients can easily navigate their benefits and access needed healthcare services. Devoted Health is committed to helping customers save money and enhance their health and wellness through a complete package of benefits and support.

📋 Description

• Assist in development and maintenance of an efficient utilization management program • Perform clinical reviews, including Part A, Part B, appeals, and quality of care reviews • Conduct peer-to-peer discussions • Participate in inter-rater reliability activities • Analyze utilization data and suggest improvement opportunities • Provide mentoring and leadership to clinical teams • Develop relationships supporting growth and fiscal responsibility • Participate in committees and workgroups • Provide clinical support in utilization management, quality management, clinical services, and care management programs • Serve as a clinical resource and subject matter expert to clinical and non-clinical staff throughout Devoted Health Plan • Participate in acute and post-acute clinical rounds • Conduct discussions with Devoted network physicians regarding medical policies, utilization management, resource use, and quality

🎯 Requirements

• Doctorate from an accredited school of medicine (M.D.) or osteopathy (D.O) required • Five or more years of clinical practice experience • Three (3) years of previous medical director experience working for a health plan, medical group, or hospital in utilization management or medical management

🏖️ Benefits

• Employer sponsored health, dental and vision plan with low or no premium • Generous paid time off • $100 monthly mobile or internet stipend • Stock options for all employees • Parental leave program • 401K program • Bonus eligibility for all roles excluding Director and above • Commission eligibility for Sales roles

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