Executive Job Description | Morgan Consulting Resources is an executive search firm focusing on the Healthcare Industry for 17 years. We have extensive experience in bringing together leadership talent with organizations that cover all aspects of Healthcare Services - Providers, Payers and Supporting Service organizations. We have been retained to conduct a search for a Medical Director, Medical Management for Bluegrass Family Health, Inc. in Lexington, Kentucky.
The company is a subsidiary of Baptist Health and is a not for profit managed care corporation. Bluegrass offers fully insured and self-funded services to commercial employer groups in a broad range of HMO, PPO, HRA and HSA plan designs.
The health plan is seeking an experienced Medical Director who will assist in guiding and directing the organization on issues related to the delivery of medical services in a managed care environment. This director will have responsibility for credentials, quality and appeals and for supporting utilization management, case management, disease management and pharmacy management functions. The Medical Director will assist in the development and implementation of appropriate policies, goals and objectives for medical care delivery, reporting to the Chief Medical Officer for the Plan.
This candidate will have at least three years experience with a managed care organization and 10 years of clinical experience and Board Certified in their specialty of choice. Current medical license in the state of Kentucky is a plus.
Duties and Responsibilities
" Responsible for the overall medical oversight of Credentials, Quality and Appeals functions.
" Experience and ability in leading and managing the Medical Management team.
" Develop short and long range programs for the delivery of clinical services in managed care.
" Support the monitoring, review and analysis of utilization management, Case and Disease management.
" Make customer service a priority.
" Maintain a positive working relationship with all contracted providers
" Experience in chairing physician committees, e.g. utilization, pharmacy, credentialing and quality committees.
" Ability to communicate clearly in both oral and written communication.
" Ability to stay abreast of impending changes in healthcare, e.g. healthcare reform.
" Experienced in personnel management and bringing consensus.
A more detailed position description is found on our website: www.morganconsulting.com.
Please contact Bev Meade at bev@morganconsulting.com.
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