Obstetrics & Gynecology Physician

Location:
Dallas, TX

Dallas offers a vibrant metropolitan experience with a thriving healthcare industry and diverse cultural scene. As one of Texas' largest cities, it provides excellent career opportunities while offering an attractive quality of life with outstanding dining, entertainment, and affordable living options.

Facility:
This facility is a well-established community health plan focused on providing comprehensive healthcare services to members throughout the Dallas area. The organization emphasizes a managed care approach with strong clinical oversight and quality standards to ensure optimal patient outcomes.

Opportunity:
Board Certified - OB/GYN Associate Medical Director

Job Details:
• 13-week locum assignment with potential transition to permanent role
• Reviews prior authorization and appeals requests based on medical necessity
• Performs peer-to-peer calls to support utilization management processes
• Provides clinical oversight for utilization management, disease management, and quality management activities
• Develops medical policies and procedures for coverage, authorization, and clinical guidelines
• Analyzes data to establish healthcare provider profiles and evaluate physician performance
• Assists with overseeing and administering pharmacy benefits for members
• Participates in fraud, waste, and abuse programs oversight
• Assists in identifying member and provider education needs
• May represent the organization in clinical activities with State and local bodies
• Participates in process improvement initiatives for clinical areas
• Serves on various managed care committees as assigned
• Must have Texas medical license or willingness to obtain one
• Clean malpractice and license history required
• Must have experience in managed care and prior authorization
• Requires familiarity with Texas Medicaid Regulations
• Must demonstrate strong leadership, organizational, and communication skills
• Knowledge of care coordination, population health, and evidence-based care principles required

Compensation:
Competitive hourly rates with weekly pay and malpractice included.