Medical Director - Medicare Case Management
Posted 2025-03-15Description:
? 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.
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