Associate Medical Director jobs in Ohio

Associate Medical Director supports the implementation of medical policies for the entire organization. Ensures the delivery of quality patient care. Being an Associate Medical Director researches and evaluates new treatments and medical innovations. Works collaboratively throughout the organization to ensure the adoption of standards and policies for all functional aspects of clinical services that result in patient care improvements. Additionally, Associate Medical Director requires a MD degree. Typically reports to Medical Director. The Associate Medical Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. To be an Associate Medical Director typically requires 5+ years of managerial experience. (Copyright 2024 Salary.com)

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Associate Medical Director
  • CommuniCare Advantage
  • Cincinnati, OH FULL_TIME
  • Associate Medical Director

    The CommuniCare Family of Companies currently owns/operates more than 85 Nursing and Rehabilitation Centers, Specialty Care Centers and Assisted Living Communities in 7 states. Since 1984, CommuniCare Health Services has provided superior, comprehensive management services for the development and management of adult living communities.
    Due to growth, we are seeking an experienced Associate Medical Director.

    The position of part-time Associate Medical Director is responsible for supporting the Medicare Advantage Plans clinical and quality activities and operations at the direction of the Chief Medical Officer approximately 25 hours per week. This position reports directly to the Chief Medical Officer, Medicare Advantage Plans.
    Job duties & responsibilities may include the following and will be finalized based on the skills and interests of the successful candidate:
    • Medical Management
    • Support strategies and interventions to improve quality outcomes, medical expense trends, and STARS ratings
    • Health Care Services Management
    • Conduct prior authorization and utilization management activities including adverse determinations.
    • Collaborate with consultant physicians as necessary to review selected authorization requests or appeals of adverse determinations.
    • Support processes relating to performance and audit of vendors or provider organizations delegated for UM.
    • Lead review and submission of clinical practice guidelines, utilization and concurrent review criteria, and other similar guidelines to Medical Policy or applicable committees.
    • Participate in Plan committees such as Medical Policy, Credentialing, Quality Improvement, Peer Review and others as assigned.
    • Collaborate with medical directors and other clinical leaders from across the contracted network including CHS affiliates as on assigned projects .
    • Support care innovations across the enterprise
    Support the implementation and execution of the Quality Assurance Plan including but not limited to:
    • Models of Care
    • STARS and clinical quality
    • Member and provider satisfaction
    • Provider network accessibility, availability and qualifications]
    • Grievance and Appeals
    • Support the development and implementation of the Models of Care across the health plan, the CHS Family of Companies and network of providers.
    • Plan Pharmacy Operations
    • Participate in various pharmacy related meetings or activities as assigned.
    • Support processes related to pharmacy appeals process including appeals of adverse determinations.
    • Regulatory and Compliance
    • Assure consistent, high quality execution on HIPAA, Privacy, Program Integrity and Fraud, Waste and Abuse protections and activities
    • Complete annual Plan compliance training, IRR, and other compliance-related activities.
    • Assure adherence to documentation and requirements as set forth in the Model of Care for each MA SNP plan
    • Assure adherence to regulatory requirements regarding Quality Committees including Quality Improvement, Credentialing, Medical Policy, Peer Review, Quality of Care committees and related activities
    • Growth and Census Support
    • Physician Recruitment: Medical Directors, Specialty Physician Program Directors, Attending Physicians
    • Attain and enhance physician and hospital relationships to increase referrals
    • Participate in data reviews, sharing and initiatives to improve member outcomes
    • Liaison to providers when necessary to solicit participation in the Plan provider network, committees or to address QOC or other issues.
    • Serve as ambassador to other enterpriseMedical Directors and clinical leaders
    Qualifications & Experience requirements
    • Requires a degree in medicine from an accredited school, Board Certification, and is licensed to practice in applicable states in which the Plan operates.
    • Requires at least 15 years of Clinical Experience.
    • Requires 3 to 5 years prior experience as a CMO or Associate Medical Director preferably for a Medicare, MMP, or Medicaid plan inclusive of dually eligible enrollees.
    • Experience in working in post-acute facilities, assisted living facilities, home and community-based service settings preferred.
    • Geriatric training and experience preferred but not required.
  • 20 Days Ago

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Associate Medical Director
  • Neighborhood Health Association
  • Toledo, OH FULL_TIME
  • Medical Director Neighborhood Health Association - Under the direction of the Chief Medical Officer (CMO), provides direction and over sight for the nurse practitioners, the development and oversight ...
  • 22 Days Ago

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Associate Medical Director
  • Neighborhood Health Association
  • Toledo, OH OTHER
  • Medical Director Neighborhood Health Association - Under the direction of the Chief Medical Officer (CMO), provides direction and over sight for the nurse practitioners, the development and oversight ...
  • 24 Days Ago

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Associate Medical Director
  • Western & Southern Financial Group
  • CINCINNATI, OH FULL_TIME
  • Overview Summary of Responsibilities: Performs medical underwriting/medical risk analysis, establishes underwriting standards, and reads EKG's for Western & Southern and Columbus Life New Business. Ac...
  • Just Posted

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Associate Medical Director
  • VITAS Healthcare
  • Moraine, OH FULL_TIME
  • The medical director of VITAS fulfills two primary functions, each of which is expected to consume approximately one half of the time and work effort of the position: The medical director has overall ...
  • 4 Days Ago

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Associate Medical Director
  • CommuniCare Family of Companies
  • Cincinnati, OH FULL_TIME
  • Associate Medical Director The CommuniCare Family of Companies currently owns/operates more than 85 Nursing and Rehabilitation Centers, Specialty Care Centers and Assisted Living Communities in 7 stat...
  • 9 Days Ago

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Associate Medical Director
  • Humana Inc.
  • Edinburg, TX
  • Become a part of our caring community and help us put health first The Associate Medical Director serves as a health-car...
  • 3/28/2024 12:00:00 AM

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Associate Medical Director
  • Humana
  • Daytona Beach, FL
  • Become a part of our caring community and help us put health first The Associate Medical Director serves as a health-car...
  • 3/28/2024 12:00:00 AM

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Associate Medical Director of Respite
  • Boston Health Care for the Homeless Program
  • Boston, MA
  • Since 1985, BHCHPs mission has been to ensure unconditionally equitable and dignified access to the highest quality heal...
  • 3/28/2024 12:00:00 AM

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ASSOCIATE MEDICAL DIRECTOR
  • The Institute for Family Health
  • Kingston, NY
  • SUMMARY: Responsible for the overall clinical management of the practice and program assigned to the practice as above...
  • 3/27/2024 12:00:00 AM

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Associate Medical Director, Psychiatry
  • Signature Health
  • Maple Heights, OH
  • Associate Medical Director - Psychiatry Are you looking for an organization where you can make a positive impact in peop...
  • 3/27/2024 12:00:00 AM

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Associate Medical Director
  • MedPOINT Management
  • Los Angeles, CA
  • Job Description Job Description MedPOINT Management (MPM) Department: Utilization Management (UM) Title Associate Medica...
  • 3/24/2024 12:00:00 AM

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Associate Medical Director
  • MedPOINT Management
  • Santa Clarita, CA
  • Job Description Job Description MedPOINT Management (MPM) Department: Utilization Management (UM) Title Associate Medica...
  • 3/24/2024 12:00:00 AM

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Associate Medical Director
  • VITAS Healthcare
  • Daytona Beach, FL
  • Job Description The medical director of VITAS fulfills two primary functions, each of which is expected to consume appro...
  • 3/24/2024 12:00:00 AM

Ohio /oʊˈhaɪoʊ/ (listen) is a Midwestern state in the Great Lakes region of the United States. Of the fifty states, it is the 34th largest by area, the seventh most populous, and the tenth most densely populated. The state's capital and largest city is Columbus. The state takes its name from the Ohio River, whose name in turn originated from the Seneca word ohiːyo', meaning "good river", "great river" or "large creek". Partitioned from the Northwest Territory, Ohio was the 17th state admitted to the Union on March 1, 1803, and the first under the Northwest Ordinance. Ohio is historically know...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Associate Medical Director jobs
$290,906 to $385,258

Associate Medical Director in Rochester, MN
The Associate Medical Director - Team Physician will Work with the Medical Director and appropriate Manager, Clinical Team to plan, provide and evaluate clinical care.
January 10, 2020
Associate Medical Director in Biloxi, MS
We are committed to improving patient outcomes and the Associate Medical Director vacancies will perform a crucial role in enabling patient’s access vital medications.
November 30, 2019
Associate Medical Director in Dallas, TX
The Associate Medical Director provides clinical supervision and mentoring to these programs’ emergency medical services staff, and, as a key member of CCC’s Substance Use Disorder Services (SUDS) leadership team, contributes to setting strategic direction for these programs.
December 14, 2019