Associate Medical Director – UM PT

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🕒 June 12

🐊 Florida, New York, +3 more states – Remote

🐊 Florida – Remote 🗽 New York – Remote 🌲 North Carolina – Remote 🌴 South Carolina – Remote 🤠 Texas – Remote

💵 $115 - $155 / hour

⏱ Part Time

🔴 Lead

👨‍⚕️ Medical Director

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Independent Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

⚕️ Healthcare Insurance

🛡️ Insurance

Healthcare • Healthcare Insurance • Insurance

Independent Health is one of Western New York's first Health Maintenance Organizations (HMOs) and provides health insurance coverage to approximately 355,000 individuals with over 100 plans, services, and products. The company specializes in health insurance, pharmacy benefits, Medicare Advantage, and self-funded plans, promoting a culture that emphasizes bringing out the best in its members and staff.

📋 Description

• Responsible for assisting the Medical Director in the oversight of Utilization Management (UM) programs • Support the development and maintenance of these programs, focusing on clinical accuracy and appropriateness • Assist the Medical Director in developing strategic corporate direction for UM programs • Support the SVP, Healthcare Services in preparing annual metrics of results for UM programs • Contribute to measurable outcomes for prior authorization, step therapy, and quantity limit programs • Collaborate with internal teams to support corporate HEDIS initiatives with appropriate clinical program development • Work closely with clinical program development teams, clinical service operations, and clinical quality committees • Provide clinical guidance and oversight to these areas • Serve on IH committees as directed by the Medical Director

🎯 Requirements

• Graduate Degree required from an accredited medical school and residency program required • Master’s degree in healthcare administration, business, or public health preferred • Possess an unrestricted, current, active license to practice medicine, issued by the NY State Board of Licensure or the State Board of Osteopathic Examiners • Must be a member in good standing in the medical community • Board certified in a recognized medical specialty as recognized by the American Board of Medical Specialists (ABMS), preferably in Primary Care (internal medicine, family practice, etc.) preferred • Five (5) years of post-graduate clinical experience in health care management and utilization review required; quality assurance and peer review experience preferred • Private practice experience preferred • Ability to rotate in UM call schedule to remotely cover evenings, weekends and holidays • Excellent verbal, written and interpersonal communication skills required • Solid computer navigational skills required • Demonstrated ability to work effectively as a member of a multi-disciplinary team • Demonstrated ability to analyze, interpret and communicate significance of health care data • Proven examples of displaying the IH values: Passionate, Caring, Respectful, Trustworthy, Collaborative, and Accountable.

🏖️ Benefits

• Full range of benefits • Generous paid time off • Scorecard incentive