Medical Director - Medicare Case Management
Description:
Provides clinical oversight of case management teams.
Participates in the development of Individual Care Plans (ICP).
Collaborates with leadership to ensure objectives are met.
Consults with plan medical staff on adverse determinations.
Delivers highest quality care in an effective manner.
Contributes to strategies and programs for community engagement.
Develops clinical training for case management staff.
Ensures timely execution of all deliverables.
Interprets utilization data and proposes clinical improvements.
Participates in UM activities and on-call schedule as needed.
Requirements:
Active and current medical license in Florida (MD or DO).
Board Certification in Family Practice, Internal Medicine, or Geriatrics.
Post-graduate direct patient care experience.
3-5 years of Managed Care experience; Medicare highly preferred.
3-5 years of Case Management experience.
Ability to work effectively in a highly matrixed organization.
Ability to engage with all levels including clinical leaders and staff.
Flexibility with work schedule to meet business needs.
Ability to be agile and manage multiple priorities.
Benefits:
Full range of medical, dental, and vision benefits.
401(k) retirement savings plan.
Employee Stock Purchase Plan available.
Fully-paid term life insurance plan.
Short-term and long-term disability benefits.
Numerous well-being programs.
Education assistance and free development courses.
CVS store discount and discount programs with partners.
Paid Time Off (PTO) and paid holidays.
Apply Now
Provides clinical oversight of case management teams.
Participates in the development of Individual Care Plans (ICP).
Collaborates with leadership to ensure objectives are met.
Consults with plan medical staff on adverse determinations.
Delivers highest quality care in an effective manner.
Contributes to strategies and programs for community engagement.
Develops clinical training for case management staff.
Ensures timely execution of all deliverables.
Interprets utilization data and proposes clinical improvements.
Participates in UM activities and on-call schedule as needed.
Requirements:
Active and current medical license in Florida (MD or DO).
Board Certification in Family Practice, Internal Medicine, or Geriatrics.
Post-graduate direct patient care experience.
3-5 years of Managed Care experience; Medicare highly preferred.
3-5 years of Case Management experience.
Ability to work effectively in a highly matrixed organization.
Ability to engage with all levels including clinical leaders and staff.
Flexibility with work schedule to meet business needs.
Ability to be agile and manage multiple priorities.
Benefits:
Full range of medical, dental, and vision benefits.
401(k) retirement savings plan.
Employee Stock Purchase Plan available.
Fully-paid term life insurance plan.
Short-term and long-term disability benefits.
Numerous well-being programs.
Education assistance and free development courses.
CVS store discount and discount programs with partners.
Paid Time Off (PTO) and paid holidays.
Apply Now