CareSource
Medicaid • MyCare Ohio • Health Insurance Marketplace • Medicare Advantage • Health Insurance
1001 - 5000
Medical Director
September 27
CareSource
Medicaid • MyCare Ohio • Health Insurance Marketplace • Medicare Advantage • Health Insurance
1001 - 5000
Description
• Responsible for training, clinical consultation, and case review for members • Provide prior authorization medical reviews and consultations • Participate in quality improvement initiatives and member safety activities • Evaluate and investigate cases of fraud and quality of care concerns • Collaborate with market leaders on strategy and standards
Requirements
• Completion of an accredited Medical Degree program as an MD or DO • Successful completion of a residency training program, preferably in primary care • Minimum of five (5) years of clinical practice experience • Managed care medical review/medical director experience preferred • Bachelor's or Master's degree in Business Administration, Operational Excellence, Healthcare Administration or Medical Management preferred • Current, unrestricted license to practice medicine in state of practice • Board Certification, preferably in primary care specialty required • MCG Certification is required or must be obtained within six (6) months of hire
Benefits
• Substantial and comprehensive total rewards package • Investment in employee well-being
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