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Medical Director - Network Support
NPAworldwide Recruitment Network
NPAworldwide Recruitment Network
 
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Job Location: Pittsburgh, PA
JOB DESCRIPTION

Job #: 13991
Title: Medical Director - Network Support
Job Location: Pittsburgh, Pennsylvania - United States
Employment Type:
Salary: $170,000.00 - $245,000.00 - US Dollars - Yearly
Employer Will Recruit From: Regional
Relocation Paid?: Negotiable

WHY IS THIS A GREAT OPPORTUNITY?

Medical Director - Network Support

Direct Hire - Full-time

WHY WE`RE A GREAT COMPANY

A lot of organizations provide people medical services. At this company, we believe in going further. We believe, if you care for the entire community, you`ll see a positive impact. We believe that our members don`t just benefit from personalized care - they deserve it. And we believe in working with you, to find the best quality of care that works with your budget.

JOB DESCRIPTION

RESPONSIBILITIES

  • Provide and interpret provider-specific clinical data to facilitate optimal interventions and significant clinical and financial results.
  • Analyze clinical data to help providers use such data to take action.
  • Engage providers with analyses and recommendations that address the present and future health status of their enrolled members, including high cost claimants and dependents.
  • Contribute to the development of new reports that simplify complex data sets.
  • Provide clients with recommendations that will impact medical cost trends.
  • Provide effective presentations to providers and others on the Organizations clinical capabilities across the care management continuum.
  • Communicate the company`s clinical value proposition, based on clinical capabilities, provider data, clinical value of products, pay for value care strategies, and population health analytics.
  • Work with provider-relations and clinical operations staff to develop provider-specific health management strategies, i.e., action plans that address provider-specific clinical and financial risk, and justify investments in behavior change interventions.
  • Develop, maintain, and document strong working relationships with providers, consultants and other stakeholders in order to provide dedicated support and add value to the account relationship through clinical analysis, education, and presence.
  • Proactively maintain strong provider relationships through regular outreach through the year.
  • Work collaboratively with various internal and external leaders to ensure that a provider`s specific clinical data will drive the right interventions for the right members. This is accomplished through the use of population health analytics reports, and input from other internal departments and consultants.
  • Provide expert support, as needed, to various internal entities through project facilitation, conducting meetings, attending prep meetings, and other contributions of clinical expertise.
  • Demonstrate support for the innovation and change needed to improve effectiveness.
  • Understand the current regional and national health care environment and the company`s position on health care issues.
  • Understand and apply privacy regulations.

COMPENSATION

  • Full-time Benefits - Full
  • Relocation Assistance Available - Possible for ideal candidate
  • Commission Compensation - No
  • Bonus Eligible - No
  • Overtime Eligible - No
  • Interview Travel Reimbursed - No
QUALIFICATIONS

This position requires business savvy, flexibility, tact, and the ability to build internal and external relationships.

Medical Degree (MD or DO)

Master`s Degree in Business Administration/Management or related discipline

Current, active and unrestricted PA Medical License

Current Board certification in ABMS specialty

Willingness to Travel - Always

EXPERIENCE

Required

  • 5 - 7 years in the Healthcare Industry
  • 5 - 7 years in Clinical Service

Preferred

  • 10 - 15 years in Clinical Practice
  • 5 - 7 years in Management
  • 1 - 3 years in the Health Insurance Industry
  • 1 - 3 years in Provider Services
  • 1 - 3 years in Communications
  • 1 - 3 years in Client Management
  • 1 - 3 years in Value-Based Payment Programs

Education:
University - MD


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