Medical Director at The Judge Group Inc. in Wheeling, West Virginia

Job Description:

Location: Wheeling, WV

Salary: $250,000.00 USD Annually - $275,000.00 USD Annually

Description: Judge Healthcare is currently seeking a Medical Director for one of our biggest clients in Wheeling, WV!

Hours: Full time Mon-Fri 8am-5pm
Location: Wheeling WV in office but may move to hybrid. RELOCATION ASSISTANCE AVAILABLE!

Type: Permanent!
Pay: Flexible and based on experience

Summary: Medical Professional is responsible for direction and oversight of healthcare services provided to Plan members to ensure the delivery of cost-effective, quality services. The Medical Director shall be responsible for Medical Direction of all activities of the Quality Management and Utilization Management Programs. This will be a Dyad relationship with the Directors of Utilization and Quality Management and Pharmacy Management.

Responsibilities:
1. Provide Physician oversight for activities related to the company's Utilization Management,
Disease Management and Quality Management programs ensuring compliance with NCQA,
Medicare, Medicaid, and other regulatory entities. Play an active role in preparing for related
audits and information requests from such entities.
2. Establish the highest standards of best medical practices for care provided to members through
participation in the development of clinical practice guidelines and selection and procurement
of suitable proprietary criteria and clinical pathways.
3. Provide physician education regarding utilization management and quality management protocols and initiatives. Work with individual physicians or physician groups to achieve acceptance and understanding of medical appropriateness criteria, practice guidelines and patient care programs.

Qualifications & Requirements:

1. MD/DO with board certification in Internal or Family
2. A West Virginia and Ohio Physician License is required. Or willingness to obtain them within 90 days.
3. A minimum of three years of clinical experience beyond residency/fellowship is necessary, with supervisory and teaching experience preferred
4. Previous Utilization Management experience



Are you or someone you know interested? Reach out to Britney Bishop at bbishop@judge.com with any questions!

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Contact: bbishop@judge.com


This job and many more are available through The Judge Group. Find us on the web at www.judge.com Apply Now