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Medical Director - MedStar Family Choice - Remote Opportunity

Role overview

Qualifications

  • MD or DO Degree
  • BC in Primary Care
  • 5 years clinical experience in Primary Care
  • Health Plan experience preferred

Responsibilities

  • Participate in the development and execution of case management and disease management
  • Conduct daily review of inpatients, precertification requests, and pharmacy requests
  • Review emergency department visits, appeals, and consultations with nurse case managers
  • Make utilization review decisions based on medical necessity and coverage

Key facts

Hard skills

Other skills

  • Communication
  • Teamwork

About the company

MedStar Health logo

MedStar Health

Hospitals & Health Care

MedStar Health is a not-for-profit health system dedicated to caring for people in Maryland and the Washington, D.C., region, while advancing the practice of medicine through education, innovation and research. MedStar’s 30,000 associates, 6,000 affiliated physicians, 10 hospitals, ambulatory care and urgent care centers, and the MedStar Health Research Institute are recognized regionally and nationally for excellence in medical care. As the medical education and clinical partner of Georgetown University, MedStar trains more than 1,100 medical residents annually. MedStar Health’s patient-first philosophy combines care, compassion and clinical excellence with an emphasis on customer service.

Company details

Company typeXLarge
IndustryHospitals & Health Care
Company size10001

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Job description

About this Job:

Health Plan Medical Director Physician - MedStar Family Choice - Remote Opportunity

MedStar Health offers a uniquely rewarding career in a major marketplace. Shape your future in health care in the kind of setting that’s right for you and your practice. Become part of an organization that welcomes your experience and input — as a clinician and healthcare expert.

We are looking for a physician with primary care and health plan experience to join MedStar Family Choice, our Medicaid Managed Care organization, as the health plan Medical Director in the Baltimore, MD area. In this position you will participate in the development and daily execution of case management, disease management, population health management, utilization review and other operations of the health plan. You will also conduct a daily review of current inpatients, precertification requests, pharmacy requests, review of emergency department visits, review of appeals, and consultations with nurse case managers and other associates to ensure the daily operations of the plan. Utilization review decisions for members of MedStar Family Choice (MFC) are made according to Utilization Management (UM) criteria and based on medical necessity and the existence of coverage.

Qualifications:

  • MD or DO Degree 
  • BC in Primary Care
  • 5 years clinical experience in Primary Care
  • Health Plan experience preferred
  • Must reside in the DC/Maryland area
  • DC and Maryland Licensure
  • Demonstrated commitment to ongoing clinical excellence and professional development.

This is a remote telehealth work opportunity.

As a MedStar Health associate, you can expect:

  • A competitive salary
  • Medical, dental and vision insurance
  • Paid medical licensing and malpractice insurance
  • Generous paid time off
  • CME leave and CME allowance
  • Retirement savings plan with employer match

Be a part of a nationally - recognized health system and the largest provider of health services in the Maryland region. With our vast resources and capabilities at your disposal, you can expand your clinical expertise. Enjoy a rich career and a quality of life unique to the Mid-Atlantic region, which features a mix of urban, suburban and rural communities.
 

Be the provider you were meant to be, here at MedStar Health.

MedStar Health is the largest health system in the region, with 30,000 associates, working at 10 hospitals, hundreds of ambulatory care sites – all together more than 700 access points of care, covering more than 225 zip codes in 17 counties.  We are also ranked among the “Best Places to Work” by Baltimore magazine, Baltimore Business Journal, and Washington Business Journal.

MedStar Health is committed to equity for all people and communities.  A proud member of the Institute for Diversity in Healthcare Management, we are committed to expanding career and leadership opportunities for ethnically, culturally, and racially diverse individuals.  We continue to build a diverse and inclusive workplace where people feel a sense of belonging and accomplishment at all levels of the organization.  As a leader in healthcare, we are taking action to evolve our organization and bring unique, multidimensional perspectives together to deliver equitable care, improve the health of the communities we serve, and contribute to the advancement of the healthcare industry overall.

 At MedStar Health, we believe diverse teams and perspectives make us stronger, lead to better care for our patients, and foster a supportive work experience for our associates. Our commitment to diversity is built into our SPIRIT values, where we acknowledge that teamwork and system effectiveness is built on the collective strength and cultural diversity of everyone working with open communication and mutual respect.

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This position has a hiring range of : USD $20.00 - USD $20.00 /Yr.

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Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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