Medical Director - Medicare Case Management

Description:
• Provides clinical oversight of case management teams.
• Participates in the development of Individual Care Plans (ICP).
• Collaborates with leadership to ensure objectives are met.
• Consults with plan medical staff on adverse determinations.
• Delivers highest quality care in an effective manner.
• Contributes to strategies and programs for community engagement.
• Develops clinical training for case management staff.
• Ensures timely execution of all deliverables.
• Interprets utilization data and proposes clinical improvements.
• Participates in UM activities and on-call schedule as needed.

Requirements: • Active and current medical license in Florida (MD or DO). • Board Certification in Family Practice, Internal Medicine, or Geriatrics. • Post-graduate direct patient care experience. • 3-5 years of Managed Care experience; Medicare highly preferred. • 3-5 years of Case Management experience. • Ability to work effectively in a highly matrixed organization. • Ability to engage with all levels including clinical leaders and staff. • Flexibility with work schedule to meet business needs. • Ability to be agile and manage multiple priorities.

Benefits:
• Full range of medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Employee Stock Purchase Plan available.
• Fully-paid term life insurance plan.
• Short-term and long-term disability benefits.
• Numerous well-being programs.
• Education assistance and free development courses.
• CVS store discount and discount programs with partners.
• Paid Time Off (PTO) and paid holidays.

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