Medical Director

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🔥 0 minutes ago

🦀 Maryland – Remote

🦀 Maryland – Remote

💵 $266k - $315k / year

⏰ Full Time

🔴 Lead

👨‍⚕️ Medical Director

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Maryland Primary Care Physicians

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 1996

🏥 Healthcare

👥 B2C

🧘 Wellness

Healthcare • B2C • Wellness

Maryland Primary Care Physicians is a physician-owned primary care group serving families across Central Maryland, offering patient-centered comprehensive care at multiple office locations. They provide primary and preventive care, pediatric and family services, same-day sick visits, after-hours and weekend telemedicine, onsite lab testing, and integrated specialty services including cardiology, endocrinology, genetics, and nutrition. The practice emphasizes continuity of care, community roots, online appointment scheduling, a patient portal for 24/7 access, and coordinated care across specialties to support patients through every stage of life.

📋 Description

• Lead and participate in the Maryland Physicians Care MCO’s Medical Management Program • Assist in developing and implementing comprehensive medical policies and standards of care • Provide leadership for the Health Management Teams • Supervise Utilization Management, Quality Management, and Inpatient Concurrent Review • Interact with providers • Participate in Quality Management and Utilization Management processes • Confer with health professionals or providers regarding concurrent review questions • Conduct peer-to-peer clinical case reviews with attending physicians, physician advisors, or ordering providers • Provide medical support and direction to the Pre-Authorization Unit for elective consultations, procedures, tests, and formulary requests • Identify and report quality-of-care issues • Participate in Grievance and Appeals Review Processes • Participate in QM/UM, Pharmacy and Therapeutics, and Credentialing Committees as needed • Round regularly with concurrent review nurses to discuss inpatient members • Participate in EQRO and HEDIS audits as needed • Perform other assigned duties, potentially supervising nurses and associate medical directors

🎯 Requirements

• M.D. or D.O. unencumbered license • 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 of local, regional, and national provider medical standards of care • Knowledge of Medicaid and Commercial regulatory requirements is beneficial • Knowledge and familiarity with contracts and policies as they pertain to the managed care environment • 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

🏖️ 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 • Multiple work arrangements • Organizational-wide social opportunities