Located on Long Island, Garden City is a beautiful community with excellent schools. Take advantage of this great opportunity!
The Regional Medical Director is responsible for management of clinical resources through utilization management. (S)he reports clinically to the Chief Medical Officer. The Regional Medical Director performs a broad range of utilization management (UM) and quality management (QM) functions as assigned in support of appropriate clinical practice for the benefit of members. The Regional Medical Director works collegially with fellow team members in the Clinical Services Department and administrative offices to fulfill the mission and attain the objectives of the organization. Typical duties and job responsibilities include:*Management of institutional clinical resources through utilization management. *Clinical review of referral requests. *Contributes to improvement in delivery of covered health services to members. *Participates as assigned in clinical services programs including: case management programs and disease management programs. *Discusses treatment plans with physicians. *Participates in the development and maintenance of a Hospitalist program. *Takes part in grievance and appeals processes. *Participates in training participating physicians and facilities staff members in processes and clinical guidelines.*Participates in the management of outpatient/specialty referral programs as assigned.*Participates in committees such as: credentialing, medical advisory, utilization management, etc. as assigned.*Assists with on-call coverage for UM activities as assigned.*Supports departments and functions as needed.Job Requirements:Requires a medical degree (MD) from an accredited medical school and a minimum of 5-7 years of clinical practice experience. Direct managed care experience preferred.MUST BE BOARD CERTIFIED (Board certification in internal medicine preferred.)We offer a competitive compensation package and an attractive benefits package including: Medical, Dental, Short Term Disability, 401k, Paid Time Off