DaVita
Network Health's success is rooted in its mission to create healthy and strong Wisconsin communities. Network Health is seeking an Associate Medical Director. The Associate Medical Director is responsible for the administration of procedures, protocols, and standards regarding the efficiency and quality of the health care delivered to Network Health Plan (NHP) members.
Location:
Candidates must reside in Wisconsin. This position is eligible for remote work (reliable internet required). Occasional travel may be necessary. Hours:
0.5 FTE, 8am - 5pm on Tuesday, Thursday, and Friday Check out our 2024 Community Report to learn more about how our employees make a difference in our communities. As an employee, you will have opportunities to work hard, have fun, and volunteer locally. Apply now to join our team and make an impact. Job Responsibilities: Align with Network Health's philosophy, mission, values, and vision Follow organizational and regulatory policies and procedures Promote quality and service excellence with clients, members, physicians, staff, and visitors, fostering teamwork Assist the Chief Medical Officer (CMO) in monitoring care appropriateness and availability among providers Participate in utilization management, including making denial determinations for non-medically necessary or experimental services Contribute to developing quality care guidelines, peer review procedures, and medical care evaluation studies Foster positive relationships with the medical community Serve as a liaison on medical policy and administration matters Represent NHP in the medical community and maintain contact with professional organizations Participate in recruiting plan physicians Assist in developing medical guidelines for claims review Train NHP staff on medical guidelines Work with the Utilization Management team on claims review Serve on committees as coordinated with the CMO Support strategic planning for plan growth Perform additional duties as assigned
Job Requirements: Doctor of Medicine (MD or DO), licensed in Wisconsin without restrictions Management or managed care courses preferred Experience on management committees required Medical director experience preferred Knowledge of managed care, utilization management, case management, quality, and population health preferred
Network Health is an Equal Opportunity Employer #J-18808-Ljbffr
Candidates must reside in Wisconsin. This position is eligible for remote work (reliable internet required). Occasional travel may be necessary. Hours:
0.5 FTE, 8am - 5pm on Tuesday, Thursday, and Friday Check out our 2024 Community Report to learn more about how our employees make a difference in our communities. As an employee, you will have opportunities to work hard, have fun, and volunteer locally. Apply now to join our team and make an impact. Job Responsibilities: Align with Network Health's philosophy, mission, values, and vision Follow organizational and regulatory policies and procedures Promote quality and service excellence with clients, members, physicians, staff, and visitors, fostering teamwork Assist the Chief Medical Officer (CMO) in monitoring care appropriateness and availability among providers Participate in utilization management, including making denial determinations for non-medically necessary or experimental services Contribute to developing quality care guidelines, peer review procedures, and medical care evaluation studies Foster positive relationships with the medical community Serve as a liaison on medical policy and administration matters Represent NHP in the medical community and maintain contact with professional organizations Participate in recruiting plan physicians Assist in developing medical guidelines for claims review Train NHP staff on medical guidelines Work with the Utilization Management team on claims review Serve on committees as coordinated with the CMO Support strategic planning for plan growth Perform additional duties as assigned
Job Requirements: Doctor of Medicine (MD or DO), licensed in Wisconsin without restrictions Management or managed care courses preferred Experience on management committees required Medical director experience preferred Knowledge of managed care, utilization management, case management, quality, and population health preferred
Network Health is an Equal Opportunity Employer #J-18808-Ljbffr