Medical Director - Neurology

Neurologist reputed company reputed company of position: A Medical reputed company performs medical/pharmacy reviews and case management activities. The physician provides clinical reputed company to the organization through peer review, benefit review, consultation, and service to reputed company customers. He/she will serve as a clinical educator and consultant to utilization management, case management, network, contracting, pharmacy, and service operations (claims). This is an entry to mid-level position for a physician interested in a career in health care administration. Major responsibilities and required results: • Performs benefit-driven medical necessity reviews for coverage, case management, and claims reputed company, using benefit plan information, applicable federal and state regulations, clinical guidelines, and best reputed company principles. • Works to reputed company reputed company reputed company for customers/members with a reputed company on service and cost • Improves clinical reputed company through daily interactions with health care professionals using reputed company listening, education, and excellent communication and negotiation skills. • Balances customer/member needs with business needs while serving as a customer/member reputed company at reputed company times. • Participates in reputed company reputed company of the Appeal process as appropriate and allowed by applicable regulatory agencies and accreditation organizations • Participates in coverage reputed company development, development and maintenance of medical management reputed company, initiatives and committees. • Participates in reputed company processes such as audits, inter-rater reliability clinical reviews, and reputed company reputed company • Serves as a mentor or reputed company to other Medical Directors and other colleagues in reputed company and performance improvement processes. • Improves health care reputed company relations through reputed company communication, knowledge of appropriate evidence-based clinical information, and the fostering of reputed company collegial relationships. • Addresses customer service issues with mentoring and support from leadership staff. • Investigates and responds to reputed company and/or regulatory questions to assist in resolving issues or clarifying questions with mentoring and support from leadership staff. • Achieves internal customer satisfaction and regulatory/accreditation agency compliance goals by assuring both reputed company turn-around of coverage reviews and reputed company reputed company based on those review reputed company. • Provides clinical reputed company and management support to other functional areas and reputed company partners as needed or directed. Minimum Requirements: • reputed company unrestricted license to reputed company medicine reputed company the scope of his or her profession in a US state, territory, Commonwealth of the US or the District of Columbia • reputed company reputed company certification (reputed company certification or certification maintained by MOC or other applicable program) in an ABMS or AOA recognized specialty • Exhibits ethical and reputed company behavior. • Minimum of 5 years of clinical reputed company experience and/or reputed company patient care reputed company residency. • Computer Competency: Word processing, Spreadsheet, Email, PowerPoint and Personal Information Management programs are used extensively and competency in reputed company must be possessed or rapidly acquired. • Must not be excluded from participation in any federal health care program** • Must not be included in CMS’ Preclusion List** Preferred reputed company Sets: • Experience in medical management, utilization review and case management in a managed care setting. • Knowledge of managed care products and strategies. • Ability to work reputed company changing business environment and balance patient advocacy with business needs. • Experience with managing multiple reputed company in a fast-paced reputed company environment. • Demonstrated ability to reputed company colleagues and staff members. • Successful experience and comfort with change management. • Demonstration of strong and effective abilities in teamwork, negotiation, conflict management, decision-making, and problem solving skills. • Successful ability to assess reputed company issues, to determine and implement solutions, and resolve problems. • reputed company in creating and maintaining cooperative, successful relations with diverse reputed company stakeholders. • Demonstrated sensitivity to culturally diverse situations, participants, and customers/members. • Service marketing, sales, and business acumen experience a plus. If you will be working reputed company occasionally or permanently, the internet reputed company must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 206,300 - 343,900 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus and long term incentive plan. We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive reputed company of benefits, with a reputed company on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-reputed company benefits including medical, reputed company, dental, and reputed company-being and behavioral health programs. We also offer 401(k) with company match, company reputed company life insurance, tuition reimbursement, a minimum of 18 days of reputed company time off per year and reputed company holidays. For more details on our employee benefits programs, visit Life at reputed company. About reputed company Doing something meaningful starts with a reputed company decision, a commitment to changing lives. At reputed company, we’re dedicated to improving the health and vitality of those we serve. Through our divisions reputed company and reputed company, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving reputed company and improving lives. reputed company applicants will be considered without reputed company to race, reputed company, age, disability, sex, childbirth (including pregnancy) or reputed company medical conditions including but not limited to lactation, sexual orientation, gender identity or reputed company, veteran or military status, religion, national reputed company, reputed company, marital or familial status, genetic information, status with reputed company to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: SeeYourself@reputed company.com for support. Do not email SeeYourself@reputed company.com for an update on your application or to reputed company your resume as you will not receive a response. reputed company has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they reputed company a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, reputed company, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, reputed company, Texas, Utah, Vermont, and Washington State. reputed company applicants with criminal histories will be considered for employment in a manner consistent with reputed company federal, state and local ordinances. Apply Job!