ObGyn Physician position at Medical Resources Network in Columbia

Medical Resources Network is hiring ObGyn Physician on Thu, 24 Oct 2013 06:25:27 GMT. ObGyn physician employment in South Carolina : MEDICAL DIRECTOR/MANAGED CARE â€" COLUMBIA, SOUTH CAROLINA AREA -- FAMILY PRACTICE, PEDIATRIC AND OB/GYN PHYSICIANS INVITED TO APPLY!!! We are actively seeking a Medical Director/Managed Care in the Columbia, South Carolina area. The Medical Director works closely with matrix partners to manage utilization management and case management activities...

ObGyn Physician

Location: Columbia, South Carolina

Description: Medical Resources Network is hiring ObGyn Physician right now, this position will be designated in South Carolina. Detailed specification about this position opportunity kindly read the description below. employment in South Carolina :
MEDICAL DIRECTOR/MANAGED CARE â€" COLUMBIA, SOUTH CAROLINA AREA -- FAMILY PRACTICE, PEDIATRIC AND OB/GYN PHYSICIANS INVITED TO APPLY!!!

We are! actively seeking a Medical Director/Managed Care in the Columbia, South Carolina area. The Medical Director works closely with matrix partners to manage utilization management and case management activities within assigned market. The incumbent assists in the recruitment of
participating providers, supports provider relations activities, monitors and actively manages performance of participating physicians, and assists in the development and implementation of medical policy. In addition, the Medical Director works in conjunction with the Divisional Medical Director to attain quality management goals that meet or exceed quality standards as established
by all external agencies, participates in the identification and analysis of medical information from multiple sources in order to develop interventions to improve the quality of care and outcomes, and provides innovative solutions for key business drivers and leads efforts to improve upon these metrics.

E! ssential Functions:

• Leads medical management ! and quality initiatives for assigned area to include utilization management through a matrix partnership, Quality Improvement & accreditation initiatives, Pharmacy utilization, quality and cost management of provider network, and program leadership for various corporate and local initiatives designed to improve member care and minimize unnecessary costs.
• Interprets medical policy for associates to facilitate the healthcare needs

of plan members.

• Works closely with P&L owners to develop strategies to change member and

provider behavior to improve quality of care, while also reducing medical
costs.

• Works closely with and influences key business partners within a matrix

organization faced with competing priorities.

• Makes recommendations (based on daily activities of evaluating members' care)

about medical policy, clinical criteria and administrative process.

!

• Chairs medical policy, credentialing, and related health plan committees.
• Works with the medical community to assist in the development and maintenance

of a strong, quality network of providers.

• Supports provider relations and risk contracting through education, provider

visits and problem resolution.

• Visits targeted providers for recruitment, as well as performing proactive

provider visits as scheduled.

• Works with quality management and medical cost analysis staff to identify

trends in treatment and outcomes by interpreting various data.

• Reviews provider and member complaints, assist in resolution, and make

recommendations for changes.

• Utilizes clinical expertise to assist in the development of care improvement

programs to improve health outcomes for the member population.

• Manages and! develops direct reports who include directors and/or managers.
Education: A medical degree from an accredited medical school and board
certification.

Licensure: Current medical license without restrictions in South Carolina or
the ability to obtain SC license.

Experience:

• A minimum of seven (7) years’ experience and a strong working knowledge of
managed healthcare.


• Experience in Family Practice, Pediatrics, or Obstetrics and Gynecology is
highly preferred.


• Experience and familiarity with government programs is preferred.
• Past experience with NCQA accreditation is preferred.
• Demonstrated success implementing utilization tools/techniques and experience
with physician behavior modification is required.


• Participation in hospital managed care or medical practice UM committees,
desirable.


• Education, training, or professional experience in medica! l or clinical
practice.

Technical Skills/Requirements: Proficient in Microsoft Office including
Outlook, Word, and Excel.

Must haves:
Does candidate have a current medical
license without restrictions in South Carolina or the ability to obtain SC
license.

F or immediate confidential consideration, please provide a copy of your CV by email for my review to cwhite7722@aol.com and contact Charlotte White at 904.806.4080 to discuss the details.
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If you were eligible to this position, please give us your resume, with salary requirements and a resume to Medical Resources Network.

Interested on this position, just click on the Apply button, you will be redirected to the official website

This position will be started on: Thu, 24 Oct 2013 06:25:27 GMT





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