State Licensed Senior Medical Director

Job Summary

A company is looking for a Senior Medical Director (Medicare).

Key Responsibilities

• Provides leadership and expertise in clinical performance and oversight of medical necessity for member services
• Leads a team of medical directors in assessing healthcare service appropriateness and recruits and develops staff as needed
• Analyzes data for cost-savings and quality improvements while ensuring compliance with regulatory standards

Required Qualifications

• At least 8 years of relevant experience, including 2 years as a medical director in a managed care setting
• Doctor of Medicine (MD) or Doctor of Osteopathy (DO) with an active and unrestricted license
• Board Certification
• Working knowledge of healthcare laws and regulatory requirements
• Experience in strategic decision-making and collaboration in a matrixed organization