NJM Insurance Group
Auto Insurance • Workers' Compensation Insurance • Homeowners Insurance • Commercial Auto Insurance • Renters Insurance
1001 - 5000
Medical Director
September 15
NJM Insurance Group
Auto Insurance • Workers' Compensation Insurance • Homeowners Insurance • Commercial Auto Insurance • Renters Insurance
1001 - 5000
Description
• The Medical Director is a medical spokesperson for Horizon Blue Cross Blue Shield with the provider network across NJ. • Accountable for providing leadership, direction and daily support for their assigned region of NJ and assigned providers. • Responsible for a personal caseload of daily medical management activities and contributing to operational effectiveness of the medical management program. • Provides support for all lines of business including Commercial and Government Programs. • Develops and maintains effective collaborative relationships with providers in assigned geographic areas. • Performs medical reviews for the Clinical Inquiries Team (CIT) and supports special investigations unit as needed. • Acts as backup chair for committees with internal and external stakeholders.
Requirements
• Requires Board Certification in an American Board of Medicine recognized specialty. • Requires current unrestricted MD or DO license to practice Medicine. • Requires 5-7 years Clinical Experience with managing data to identify key issues, developing recommendations and providing content/conclusions to executive management. • Proficiency working with Tableau or similar software required. • Proficiency also required working with a Windows based environment including MS Office products. • Continuous Improvement Experience preferred. • Ability to review studies, understand evidence-based medicine and support medical policy development. • Ability to chair committees with internal and external stakeholders. • Active Unrestricted MD or DO License Required; NJ License Required, No CMS Sanctions or sanctions by other regulatory agencies or boards. • Must be board certified by a specialty recognized by the American Osteopathic Association or the American Board of Medical Specialties.
Benefits
• Comprehensive health benefits (Medical/Dental/Vision) • Retirement Plans • Generous PTO • Incentive Plans • Wellness Programs • Paid Volunteer Time Off • Tuition Reimbursement
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