Blue Signal Search
Our client is a leading medical group focused on bringing quality medical services and care to underserved patients in their community. They are hiring a Medical Director to oversee the daily operations of their facility with a focus in Utilization Management.
The Medical Director will be responsible for ensuring all departments are in compliance with Milliman Care Guidelines (MCG) at the IPA level. They will also oversee strategy, operation, quality, and personnel development within the department. In collaboration with the senior management team, this person will develop and implement strategic goals and programs.
This Role Offers:
• Competitive wage plus great benefits package – 100% medical/dental/vision coverage for the whole family, 401(k) match, etc.
• Fast-paced environment with likeminded self-starters.
• Culture of high performance and quality customer care.
• Work alongside a team of strong medical professionals passionate about serving their community and helping those who are underserved.
• Work to provide the motivation, tools, steps, and community that will produce lasting outcomes.
• Culture of integrity, high performance, and quality customer care.
• Help establish and expand upon existing departmental goals and objectives within utilization and case/disease management.
• Interpret and administer company medical policies and clinical guidelines.
• Generates appropriate written correspondence to providers, members, and regulatory entities.
• Identify and develop opportunities to increase medical management effectiveness and healthcare quality.
• Oversee monthly departmental, operational, and clinical data.
• Foster collaborative physician-administrative partnerships.
• Facilitate departmental quality improvement activities.
• Ensure compliance with IPA guidelines, MCG, and State/Federal regulatory agencies.
• Maintain quality and accurate medical records by following company procedures. Create reports and deliver key findings to upper management.
• Make recommendations on all personnel actions, including hiring, promoting, evaluating, disciplining, and terminating employees.
• Bachelor’s degree in healthcare or clinical studies, preferred.
• 5+ years of experience in a medical director role with a focus on UM.
• Hands on clinical experience a plus but not required.
• Strong background in working with MCG’s and authorizations.
• Must be familiar with safety regulations and techniques applicable to the healthcare environment. Background and familiarity with California laws and guidelines, preferred.
• Must have proven leadership skills and problem-solving skills including the ability to influence, motivate, and direct others.
• Must have outstanding organizational, verbal, and written communication skills.
To apply for this job please visit www.bluesignal.com.