Quality Medical Director

Quality Medical Director

Full Time Location: Jackson, MS

Primary Function: As the Quality Medical Director, you will oversee Client's Mississippi Quality Assurance team to ensure the proper provision of program services. You will serve as a clinical liaison for quality management and improvement activities for the FFS and Mississippi CAN programs.

Essential Functions:

• Oversee and have accountability for the medical review activities of the organization or assigned contracts.
• Conduct critical peer reviews to ensure the health provided is appropriate and necessary.
• Instruct other physician reviewers on critical reviews and improvement of health care.
• Assist Client staff with training physician reviewers regarding their responsibilities and functions.
• Serve as a technical expert on the peer review process.
• Participate in advisory panels as recommended.
• Represent Client policies and procedures to medical and non-medical persons.
• Participate in committee meetings representing Client.

Requirements:

• 3+ years of managing and/or working with Medicaid, government health plans, or authorization programs.
• Current unrestricted MD or DO license in the state of Mississippi.
• Current and active, unrestricted United States board certification by the American Board of Medical Specialties or Advisory Board of Osteopathic Medicine.
• Post-graduate experience in direct clinical patient care.
• Experience with Medicaid is highly preferred.