The French Group has been retained by our client, one of the
nations largest health plans, to assist in the selection of an
additional medical director. The Medical Director will work closely
with the existing team of talented physician executives and will
routinely interface with other teams such as care management,
pharmacy, network, sales and medical economics. The Medical
Director will be responsible for making medical necessity and other
benefit coverage determinations in compliance with medical
policies, protocols, product designs, and professional judgment.
She/he will also participate in Quality and Clinical Management
Committees. The Medical Director will make recommendations for
clinical product and program development, including providing
medical advice, input, and support to the full spectrum of Clinical
Management activities and programs. She/he will also collaborate
with local area medical leaders as needed and assist with the
development of provider networks and partnerships.
-Active, unrestricted licensure as an MD or DO and current ABMS
-A minimum of five years clinical experience, post-residency,
preferably managing both inpatient and outpatient care.
-At least three years experience in managed care, utilization
review and/or quality management is desirable.
-Knowledge of current and emerging medical treatment
-Familiarity with National Committee for Quality Assurance and
American Accreditation HealthCare Commission/URAC standards.
-Demonstrated public speaking and written communication
For additional information and/or confidential consideration,
please contact Tricia French at firstname.lastname@example.org