Medical Director-SelectHealth

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

Qualifications

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.

Additional Information

This is an exempt, full-time position. Pay offers are determined by prior years of relevant experience within the established pay range. 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. With this position, you are eligible to participate in the Annual Pay for Performance (AP4P) Plan. This plan enables Intermountain Health to provide leaders with an additional performance compensation opportunity. The AP4P award opportunities are calculated as a percentage of your base salary. Awards are paid out based on attainment of selected Board-approved goals.