Medical Director Job

Medical DirectorJob ID: 2011-15832 # Positions: 1Location: US-LA-Baton Rouge Search Category: Health Care AdministrationType: Regular Full-Time (30+ hours) Posted Date: 7/29/2011More information about this job:Summary:Oversees all medical care for AMERIGROUP products and services. Oversees the health care needs of the membership and serves as the principal medical manager and policy advisor to the company and health plan CEO or COO. Is accountable for and provides professional leadership and direction to the utilization/cost management and clinical quality management functions. Works collaboratively with other plan functions that interface with medical management such as provider relations, member services, benefits and claims management, etc. Assists in short and long range program planning, total quality management (quality improvement) and external relationships. Works with Corporate Health and Medical Affairs for support, assistance and direction in overall medical management effectiveness. Reports all issues of clinical quality management to the health plan CEO, COO, the Board and the Chief Medical Officer (CMO) of AMERIGROUP Corporation. Collaborates with the CMO and other health plan medical directors on national medical policies and carries out national medical policies at the health plan in collaboration with the health plan CEO or COOQualifications:EDUCATION AND EXPERIENCE:Education Required:- Masters in Public Health, MBA or MA preferred.- Continuing education to remain current in medical and management areas.- Any equivalent combination of education and experience.Years and Type of Experience Required: Required:- Five years of clinical experience in the practice of medicine, two of which have been in medical and/or health administration.- Three to five years of management and /or clinical experience in a managed care environment.Certifications or Licensure Required:- Certified in a recognized medical specialty as recognized by the American Board of Medical Specialist (ABMS).- Must be licensed in the Plan state or District of Columbia as a Doctor of Medicine or Doctor of Osteopathy.- Active license to practice medicine without restriction issued by the State Board of Licensure or the State Board of Osteopathic Examiners.Preferred:- Certification by the American Board of Quality Assurance and Utilization Review Physicians or the American Board of Medical Management desired but not required.Other Required:- Management skills to meet the organizational goals.- Must possess excellent communications skills to interface with providers, staff, and management.- Knowledge of medical, quality improvement and UM practices in a managed care environment.- Knowledge of regulatory and accreditation agencies and requirements.- Able to manage multiple priorities and deadlines in an expedient and decisive manner.- Able to manage difficult peer situations arising from medical care review.- Appreciation of cultural diversity and sensitivity towards target population.PHYSICAL REQUIREMENTS: - Must be able to operate a computer.- Must be able to operate a telephone.- Must be able to travel on common carriers and to adhere to AMERIGROUP's travel policies.- Must be able to operate a motor vehicle.- Must be able to conduct and participate in meetingsermHO