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Job Details
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Job Information:
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Job title
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Medical Director PHO -
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Company
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Wage
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between $0.00 - $0.00 Annually
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Location
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United States, Georgia, Decatur
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Employment type
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Full Time
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Education
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Not Specified
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Year Experience
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4 - 5 Years of Practical Experience
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Travel
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Not Specified
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Published on
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10/24/2011
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Description
Our client in the Atlanta are is in need of a Medical Director for the Physician Hospital Organization.
Job Description:
Direct oversight of Utilization Management including regulatory and payer requirements, appropriateness of care, length of stay, resource utilization, disease management, readmission and denial reduction strategies.
Responds in a timely manner to requests to intervene with payers, denials and appeals, observation level of care, decisions regarding admission/discharge and transition of patients through levels of care, end-of-life dilemmas, issuance of HINNS or other termination of benefits notification and other situations as requested. Co-leads the Utilization Management Committee and coordinates activities with other key committees. Assists in achievement of clinical performance initiatives including Core/ORYX Measures, patient safety, reduction in hospital-acquired infections, prevention of adverse events and reduction in mortality.
Serves as an expert resource to physicians and others regarding immediate or planned decisions regarding quality, safety, ethical, regulatory and/or financial risks incurred. Proactively integrates principles of continuous quality improvement to raise the standard of physician practice and ultimately the practice of the Hospital.
Qualifications:
Licensed to practice medicine in Georgia
Graduate of an accredited medical school; MD or DO Degree required as is Board Certification in a clinical discipline (preferably Internal Medicine or Family Practice) plus 3 years post-graduate training
Minimum of 5-10 years (recent) of clinical practice including management of ambulatory and inpatient cases
Knowledge of information technology including statistical analysis, clinical epidemiology, medical informatics, clinical protocols/guidelines, care management programs and outcome measure assessments
If you have the experience and qualifications, please apply immediately. Only those are qualified will receive a call.
We are an equal employment opportunity employer.df-hm
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Experience/Skills
Minimum of 5 years experience as a Medical Director, or similar role, in a managed care organization or an integrated healthcare system with experience in medical and utilization management
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This job has expired.
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