Regional Medical Director | MD
Job Title: Regional Medical Director | MD
Employer: MMS Group
Location: Fresno | Woodland Hills, California
Job Type: Full-Time
Career Level: Experienced
Experience: 5-10 years
Education Level: Doctorate
Regional Medical Director – MD
Can be located or relocation to – Central CA- Fresno, Woodland Hills, Rancho Cordova and Huntington Beach
- Build creditable and trusting relationships with stakeholders regarding performance metrics. Serve as liaison for the health plan to ensure that all the opportunities are highlighted through detailed reporting to the leadership at the groups. Individually own and lead HBR initiatives that ties to cost savings to the AOP for department. Serve as the clinical lead with large employer groups in the bid process.
- Manage assigned departments or functions with an emphasis on execution, outcomes, continual improvement and performance enhancement.
- Maintain relationships with key employer groups, physician groups, individual physicians, managed care organizations, and state medical associations and societies.
- Participate in quality improvement programs to assure that members receive timely, appropriate, and accessible health care.
- Provide ongoing compliance with standardized systems, policies, programs, procedures, and workflows.
- Analyze member and population data to guide and manage program direction such as ensuring that members enroll in clinical programs indicated by their clinical need and monitor performance.
- Participate in the administration of medical management programs to assure that network providers deliver and Plan members receive appropriate, high quality, cost effective care.
Assure compliance with all regulatory, accreditation, and internal requirements and audits.
- Articulate plan policies and procedures to providers and organizations and works to ensure effective implementation of policies and programs.
- May serve as a member on quality and/or care management programs and committees as directed.
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- Current CA MD license (or license in progress) and specialty board certifications
- Knowledge of the unique needs of the patient population of Central CA is necessary.
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About MMS Group:
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