Associate Medical Director
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Health Care that Starts with You!
Join a truly mission-driven organization! Independent, nonprofit UCare is recognized as one of the Minnesota???s leading health plans. We provide more than 225,000 members across Minnesota and western Wisconsin with the health coverage plans and services they need to maintain and improve their health. The innovative coverage we create makes a difference for Medicare-eligible individuals, individuals and families enrolled in Minnesota Health Care Programs, such as MinnesotaCare and Medical Assistance, and disabled adults with special health care needs. UCare is growing in size, membership, products, geographic coverage, and employees. We???re an organization that???s going places. Be part of a team that cares about you, be part of UCare.
The Associate Medical Director, along with the Chief Medical Officer and other Medical Directors, will oversee support of health care outcomes and administration of medical services for UCare’s diverse membership. Provide medical leadership and direction for the development, implementation and maintenance of excellent quality improvement, utilization management, and case management activities for UCare members. Work collaboratively with other plan functions such as Health Care Economics, Provider Relations and Contracting, Health Promotion, Claims, and Compliance. Provide support for other activities which require physician involvement. Specific duties and responsibilities include:
- Collaborate with Medical Director to provide support for the operation of the Clinical Services, Quality Management, Complaints/Appeals/Grievances, Credentialing, and Pharmacy Departments.
- Serve as a medical manager and policy advisor to the health plan, Chief Medical Officer, and Medical Director.
- Conduct reviews and case-level assessment of member care for case management, utilization management, quality improvement, complaint-appeal-grievance, and other member-level activities.
- Assist with strategic planning for medical initiatives, cost initiatives, and provider relations.
- Analyze data, clinical research, and published literature related to medical care in support of UCare’s strategic objectives.
- Support Medical Director, as needed, with the design and implementation of health plan medical policies, goals, and objectives.
- Consult with community providers and experts regarding issues of quality and appropriateness of care.
- Serve on appropriate internal and external committees particularly those affecting health care management or quality of care.
- Conduct review of clinical care of high-risk members in targeted membership groups.
- Assist the Claims Department by providing process support and medical reviews when necessary.
- Provide physician-to-physician contact regarding quality, credentials review, and utilization issues.
- Participate in the analysis and evaluation of UCare programs, policies, and procedures to determine their effects on quality of care and operational efficiency.
- Represent UCare when physician involvement on clinical issues is appropriate.
- Promote positive community relations including meetings with community groups, the academic community, and medical organizations.
- Attend meetings with regulators as appropriate and in coordination with Government Relations staff.
- Participate in the achievement and maintenance of benchmarked, clinical quality objectives, utilization, and cost management goals.
Three to five years experience in managed care environment is strongly preferred. Experience should include quality improvement, utilization review, case management, risk management, and patient care. Knowledge and advocacy of managed care principles and the primary care model required. Experience with practice guidelines and outcome data analysis preferred. Minimum of 5 years medical practice experience. Current unrestricted medical license in Minnesota as a Doctor of Medicine (MD) is required and verified throughout employment at UCare. (Note that initial temporary exemption from this requirement with a firm ending date can be negotiated at time of hiring.) Board Certification in a specialty recognized by the American Board of Medical Specialties (ABMS).
Knowledge, skills, and abilities required to be successful in this role:
- Excellent interpersonal, oral, and written communication skills.
- Excellent organizational, analytical, and problem solving skills.
- Ability to work collaboratively with other staff in a team setting.
- Ability to coordinate time-sensitive, member-related activities such as reviews with broader operational and strategic projects.
- Ability to translate clinical issues into managed care concepts and to represent these concepts to the broader community.
Please note: This position is an exciting part-time opportunity for a MD.
Enter a highly collaborative environment where people are truly engaged, and feedback is valued. You???ll enjoy a competitive salary and benefits, as well as a host of other perks, including a nationally recognized wellness program, and a bright, open, award-winning office space in Northeast Minneapolis???just minutes from major freeways and retail centers.
At UCare, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.