MEDICARE MEDICAL DIRECTOR
Company: The French Group
Location: Philadelphia
Posted on: February 25, 2021
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Job Description:
Home / Medicare Medical Director - Philadelphia, Pennsylvania
Medicare Medical Director - Philadelphia, Pennsylvania The French
Group has been retained by our client, an award-winning
not-for-profit health plan, to identify a Medicare Medical
Director. Job Summary The Medical Director will function as an
integral part of the Health Care Senior Management team with
responsibility for care management, quality management and pharmacy
services programs. This position will focus on Medicare and
Medicare Advantage, but may also be involved with other product
lines and services which have attracted seniors or disabled
individuals. This position will represent Health Care Management in
interdepartmental activities and represent the Plan in the health
system and provider communities as well as in regulatory and
governmental activities. The Medical Director will apply clinical
expertise and experience as a provider to promote the appropriate
delivery of medically necessary services to the population served.
She/he will perform utilization, pharmacy and quality reviews and
will analyze and profile utilization patterns in order to meet with
and direct network providers. The Medical Director will also be
very familiar with Medicare regulations and provide expertise and
support to the Stars program and accurate acuity scoring efforts.
Primary Responsibilities
Keywords: The French Group, Philadelphia , MEDICARE MEDICAL DIRECTOR, Executive , Philadelphia, Pennsylvania
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