Regional Medical Director Job Description

Regional Medical Director establishes and implements health care policies and standards, evaluates new treatments, and conducts medical research to ensure the quality of the medical care provided to patients for a specified region. Writes research publications to support clinical service offerings. Being a Regional Medical Director is responsible for strategic clinical relationships with physicians in the region. Oversees the development of the clinical content in marketing materials. Additionally, Regional Medical Director ensures all regional clinical programs are in compliance with laws and regulations. Requires a MD degree. Typically reports to top management. The Regional Medical Director manages a departmental function within a broader corporate function. Develops major goals to support broad functional objectives. Approves policies developed within various sub-functions and departments. Comprehensive knowledge of the overall departmental function. To be a Regional Medical Director typically requires 8+ years of managerial experience.

Regional Medical Director Job Description Template

Our company is looking for a Regional Medical Director to join our team.

Responsibilities:

  • Conducts thorough and timely Peer Reviews for Medical Directors and non-physician practitioners, according to CORIZON policy and procedures;
  • Proactively informs client of risks and high profile patient management cases and how both are being managed;
  • Partners with VPO to regularly update the client as to results, improvements needed, and how we are meeting/exceeding client expectations;
  • Improves regional results by analyzing data, developing strategies, and establishing enhanced expectations for Site Medical Directors;
  • Evaluates and treats patients in accordance with AltaMed’s standard of care;
  • Actively participate in, and work toward the achievement of target metrics in these domains;
  • Oversees and participates in the development, documentation, implementation, and interpretation of local medical policies and procedures;
  • Interact with local attending physicians on application of the Landmark Health model and issues regarding medical practice;
  • Operationalize the elements of clinical management towards those objectives in markets within the region;
  • Oversees provider education, in-service training and provider orientation;
  • Act as lead business and clinical liaison to network providers and facilities to support the effective execution of medical services programs;
  • Quality: CCIPS Implementation, STARS Optimization;
  • Responsible for supporting predetermination reviews and reviews of claim determinations, providing clinical, coding, and reimbursement expertise;
  • Other duties and responsibilities as assigned;
  • Leadership of the Interdisciplinary Care Team Meetings (ICT).

Requirements:

  • Managed care experience or experience with a large physician group in a managerial role preferred;
  • Leveraging Technology: You are technological savvy and know how to appropriately share and use your knowledge to improve business results;
  • Preferred Experience : Experience managing in a virtual environment;
  • Demonstrated experience functioning as a change agent, change champion, and/or change leader;
  • Fluency in written and spoken English required;
  • At least 3 years of primary care practice experience;
  • MD/DO degree;
  • Ensure that all committees are effectively accomplishing goals established in the QM/UM Program, and all activities are clearly documented;
  • Leads or participates on assigned committees & initiatives (e.g., Kaizan events), chairing committees as required;
  • Participates in all area(s) of responsibility to bring new business to the centers;
  • Supervise all medical services offered by the programs;
  • Provides statistical analysis of each area(s) performance;
  • Recruit, select and supervise the providers; assist in the recruitment and selection of the site’s second line of management;
  • Meet with Medical Directors and other providers as needed on quality issues at least monthly;
  • Handle grievances and incident reports on a local level. Involving HR and escalating to next level of management as appropriate.