Associate Medical Director – UM PT

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🐊 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

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1001 - 5000 employees

As one of Western New York's first HMOs, Independent Health covers approximately 355,000 people here and across the country with more than 100 plans, services and products.

📋 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