We want you to help us make your community healthier and better! We have an exciting opportunity for a Senior Medical Director based in our Mechanicsburg, PA office.

Posted by: APS Healthcare

Posted date: 05-21-2010

Location: Mechanicsburg, PA

At APS Healthcare, our mission, quite simply, is to make a significant and positive impact on the healthcare system by changing behaviors and improving outcomes. We are excited to be working with the state of PA to administer the ACCESS Plus Program, a pr

Job Title	We want you to help us make your community healthier and better! We have an exciting opportunity for a Senior Medical Director based in our Mechanicsburg, PA office.
Post Details

Posted By	APS Healthcare
Job Function	healthcare
Start Date
Salary
Phone
Location	Mechanicsburg, PA
Application Deadline

Job Description	The Sr. Medical Director supports the Executive Director by providing medical strategic direction, leadership and oversight in the areas of program design and implementation. The Medical Director oversees the ongoing day-to-day management of activities which requires clinical expertise including quality and medical appropriateness of care provided and compliance with State, regulatory and APS Healthcare guidelines and policies. Responsibilities: Establishes relationships and provides medical consultation services and oversight and consultation to clinical staff, providers and/or community Support the acquisition of new or expanded revenue or business. Identifies highly-visible events within the State at which Program representation will provide exposure and important opportunities to meet with key stakeholders. Increase participant enrollment in Case Management and Disease Management programs by promoting services to providers and consumers. Develops and conducts staff or provider education to as needed and to ensure compliance Manages Quality Improvement staff (QI Manager and QI RN Coordinators) including monitoring performance and developing goals and objectives for staff in accordance with departmental goals and objectives. Develops performance metrics for clinical and Quality Improvement (QI) staff. Identifies and reports any barriers that impact the success the program. Conducts provider liaison/education and outreach Visits 50 High Volume Practice Sites or sites in need of technical assistance related to quality improvement activities, annually, at a minimum. Chairs and convenes the Clinical Advisory Committee Participates in management meetings, clinical meetings, operational meetings and/or state meetings as required Reviews cases, quality of care, adverse outcomes, incident reports, guidelines and staff tools as needed Education: Doctor of Medicine (M.D.) or Doctor of Osteopathic Medicine (D.O.) Board certification in a primary care field Active and valid license in the State of Pennsylvania required Qualifications: Minimum of 5 years of post-graduate, post-residency clinical experience Experience with Pennsylvania Medicaid recipients, policies, data systems and processes. Knowledge of unique needs of medically underserved populations. Experience with disease management programs using the Chronic Care Model Administrative experience in managed care environment Experience in disease management, case management and provider relations; utilization review and peer review preferred Experience in program development and implementation Experience in quality improvement methodology Knowledge of disease management, case management, quality improvement, utilization review, and related data interpretation Knowledge of clinical diagnosis and management of disease processes and chronic illnesses Strong negotiation, management and leadership skills. Excellent presentation skills to diverse audiences. Excellent skills in developing business correspondences, strategic plans and program impact reports Able to work effectively with an interdisciplinary management team Ability to evaluate patient cases from nursing assessments/interventions and claims data to recommend appropriate levels of care Ability to use financial and clinical data to develop intervention strategies on the population level Evaluate organizational performance data to design program modifications Visit https://www.apshealthcare.apply2jobs.com/ProfExt/index.cfm?fuseaction= mExternal.showJob&RID=1702&CurrentPage=1 and apply online.

Category
Location	Harrisburg Area Locations -> Mechanicsburg
Job Type	Harrisburg Jobs by Type -> Full-time
Classification	Harrisburg Jobs by Classification -> Healthcare