The Medical Director is responsible for providing clinical leadership within Sentara Health Plans, aligned to one or more plans. Accountable for monitoring utilization, case management and quality outcomes. The Medical Director collaborates with the Sentara Health Plans Chief Medical Director, Senior Medical Director(s) and Clinical Care Services (CCS) teams to establish, implement, and evaluate effectiveness of clinical programs to support members and meet the department goals. Medical Director... more details
City/State
Richmond, VA
Overview
Work Shift
First (Days) (United States of America)
Job Summary
The Medical Director is responsible for providing clinical leadership within Sentara Health Plans, aligned to one or more plans. Accountable for monitoring utilization, case management and quality outcomes. The Medical Director collaborates with the Sentara Health Plans Chief Medical Director, Senior Medical Director(s) and Clinical Care Services (CCS) teams to establish, implement, and evaluate effectiveness of clinical programs to support members and meet the department goals. Medical Director activities further include support of the CCS nurses, Government services nurses, Pharmacy staff, Population Health and Quality Improvement Teams. Lastly, Medical Directors interact externally with network physicians, vended program clinical leaders, and government program leaders as required to improve the quality of clinical outcomes, cost efficiency and patient/member experience with the Health Plan and Health Systems with which we contract.
Licensed in the state of health plan coverage and board certification required. Master's level degree in Medical Management, Business Administration or Public Health preferred. Medicaid, including long term services and support, and/or Medicare, including D-SNP, experience preferred
Qualifications:
MD - Doctor of Medicine (Required)
Medical Doctor (MD) - Certification - North Carolina, Medical Doctor (MD) - Certification - Other/National, Medical Doctor (MD) - State License - Virginia Department of Health Professionals (VADHP)
Clinical Practice, Performance Improvement, Population Management, Project Management
Skills
Active Learning, Active Learning, Active Listening, Communication, Complex Problem Solving, Coordination, Critical Thinking, Judgment and Decision Making, Leadership, Learning Strategies, Mathematics, Mgmt of Financial Resources, Mgmt of Material Resources, Mgmt of Staff Resources, Microsoft Excel, Microsoft Word, Monitoring, Persuasion, Project Management, Quality Control Analysis, Reading Comprehension, Science, Service Orientation, Social Perceptiveness, Speaking {+ 5 more}
Sentara Healthcare prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
Per Clinical Laboratory Improvement Amendments (CLIA), some clinical environments require proof of education; these regulations are posted at ecfr.gov for further information. In an effort to expedite this verification requirement, we encourage you to upload your diploma or transcript at time of application.
In support of our mission “to improve health every day,” this is a tobacco-free environment.
