Medical Director, Select Health, Colorado

Medical Director

Select Health is a not-for-profit community health plan serving more than one million members in the Intermountain west across multiple states and multiple lines of business. Select Health is seeking a part-time medical director within Colorado. Reporting to the Select Health Chief Medical Officer, this Medical Director role is a part-time local Medical Director with a heavily matrixed accountability to the Select Health Market President to aid in local clinical relationships, product and plan performance and to understand local market specifics.

Essential Functions

• Reviews physician review operation and provides high-level consultation, review and medical direction.
• Provides medical consultation in the development and implementation of operational policies and procedures for the accurate and appropriate administration of contracted benefits.
• Reviews and approves all medical changes and options for all products and/or health benefits.
• Coordinates with the credentialing process including developing standards, evaluating provider credentials, advising others and resolving issues with credentialed and non-credentialed providers.
• Works with others across the organization on the paneling and contracting process to ensure appropriate outcomes.
• Participates in corporate strategic planning with other leaders across the organization and helps facilitate seamless integration by maintaining effective cross-divisional and cross-functional decision-making processes and relationships.
• Works closely and collaboratively with other departments to optimize operational success.
• Coordinates with the Medical Technology review process.
• Willingness to perform physician reviews in addition to oversee medical reviewers to ensure completeness, timeliness and accuracy.

Skills

• Leadership
• Communication
• Taking Initiative
• Performance management
• Process Improvements
• Teamwork
• Workflow optimization
• Process documentation
• Health plan operation
• Federal, state and local regulations
• Computer Literacy

Additional Information

• FTE: 0.2 / 8 hours per week
• Rate: $159.78 to $181.48 per hour based on relevant experience
• Eligible for an annual leadership incentive opportunity based on system goals
• In addition to the annual salary, to show our commitment to you and assist with your transition, we may offer a sign-on and relocation bonus when applicable.

Minimum Qualifications

• Medical Doctor or Doctor of Osteopathic Medicine degree with Board Certification in one of the following areas: Internal Medicine, Pediatrics, Family Practice, Psychiatry or Emergency Medicine.
• Requires current MD or DO licensure within the State of Utah, Idaho, Nevada or Colorado
• Five years of experience in clinical practice.

Preferred Qualifications

• Previous management experience.
• Experience with financial and medical expense management.
• Knowledge of managed care products and processes as well as the impact of managed care on the market and cost of health care
• Understanding of health care delivery system as it relates to government programs and agencies.
• Excellent communication skills including ability to establish and maintain rapport with coworkers, providers, brokers, employers, plan members, representatives/executives from other health care entities, government and regulatory bodies and others in the community.

Physical Requirements

• Ongoing need for employees to see and read information, documents, monitors, identify equipment and supplies, and be able to assess member, provider, and coworkers' needs.
• Frequent interactions with colleagues and providers require employees to verbally communicate as well as hear and understand spoken information, needs, and issues quickly and accurately.
• Frequent computer use for typing, accessing needed information, etc.

Location: SelectHealth - Lone Tree

Work City: Lone Tree

Work State: Colorado

Scheduled Weekly Hours: 40

The hourly range for this position is listed below. Actual hourly rate dependent upon experience.

$70.00 - $999.99