Medical Director-SelectHealth at Intermountain Health

Murray, Utah, United States -

Full Time

Start Date

Immediate

Expiry Date

07 Feb, 26

Salary

0.0

Posted On

09 Nov, 25

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Leadership, Communication, Taking Initiative, Performance Management, Process Improvements, Teamwork, Workflow Optimization, Process Documentation, Health Plan Operation, Federal Regulations, State Regulations, Local Regulations, Computer Literacy

Industry

Hospitals and Health Care

Description

Job Description: Select Health is a not-for-profit community health plan serving more than 1 million members in the Intermountain West. Select Health’s lines of businesses (LOB) includes Medicare, Medicaid, FEHB, Marketplace Qualified Health Plans and fully funded and self-funded Commercial plan. The Medical Director leads the achievement of physician review goals of quality service, improved efficiencies, and expense management. Additionally, the Medical Director participates in the development, communication, and implementation of strategic business plans and facilitate change. Essential Functions Reviews physician review operation and provides high-level consultation, review and medical direction. Provides medical consultation in the development and implementation of operational policies and procedures for the accurate and appropriate administration of contracted benefits. Reviews and approves all medical changes and options for all products and/or health benefits. Coordinates with the credentialing process including developing standards, evaluating provider credentials, advising others and resolving issues with credentialed and non-credentialed providers. Works with others across the organization on the paneling and contracting process to ensure appropriate outcomes. Participates in corporate strategic planning with other leaders across the organization and helps facilitate seamless integration by maintaining effective cross-divisional and cross-functional decision-making processes and relationships. Works closely and collaboratively with other departments to optimize operational success. Coordinates with the Medical Technology review process. Willingness to perform physician reviews in addition to oversee medical reviewers to ensure completeness, timeliness and accuracy. Skills Leadership Communication Taking Initiative Performance management Process Improvements Teamwork Workflow optimization Process documentation Health plan operation Federal, state and local regulations Computer Literacy Qualifications Minimum Qualifications Medical Doctor or Doctor of Osteopathic Medicine degree with Board Certification in one of the following areas: Internal Medicine, Pediatrics, Family Practice, Psychiatry or Emergency Medicine. Requires current MD or DO licensure within the State of Utah, Idaho, Nevada or Colorado Five years of experience in clinical practice. Preferred Qualifications Previous management experience. Experience with financial and medical expense management. Knowledge of managed care products and processes as well as the impact of managed care on the market and cost of health care Understanding of health care delivery system as it relates to government programs and agencies. Excellent communication skills including ability to establish and maintain rapport with coworkers, providers, brokers, employers, plan members, representatives/executives from other health care entities, government and regulatory bodies and others in the community. Additional Information This is an exempt, full-time position. Pay offers are determined by prior years of relevant experience within the established pay range. In addition to the annual salary, to show our commitment to you and assist with your transition,, we may offer a sign-on and relocation bonus when applicable. With this position, you are eligible to participate in the Annual Pay for Performance (AP4P) Plan. This plan enables Intermountain Health to provide leaders with an additional performance compensation opportunity. The AP4P award opportunities are calculated as a percentage of your base salary. Awards are paid out based on attainment of selected Board-approved goals. Physical Requirements: Physical Requirements Ongoing need for employees to see and read information, documents, monitors, identify equipment and supplies, and be able to assess member, provider, and coworkers' needs. Frequent interactions with colleagues and providers require employees to verbally communicate as well as hear and understand spoken information, needs, and issues quickly and accurately. Frequent computer use for typing, accessing needed information, etc. Location: SelectHealth - Murray Work City: Murray Work State: Utah Scheduled Weekly Hours: 40 The hourly range for this position is listed below. Actual hourly rate dependent upon experience. $7.25 - $999.99 We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged. Learn more about our comprehensive benefits package here. Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. At Intermountain Health, we use the artificial intelligence ("AI") platform, HiredScore to improve your job application experience. HiredScore helps match your skills and experiences to the best jobs for you. While HiredScore assists in reviewing applications, all final decisions are made by Intermountain personnel to ensure fairness. We protect your privacy and follow strict data protection rules. Your information is safe and used only for recruitment. Thank you for considering a career with us and experiencing our AI-enhanced recruitment process. All positions subject to close without notice. Headquartered in Utah with locations in six primary states and additional operations across the western U.S., Intermountain Health is a nonprofit system of 34 hospitals, 400+ clinics, a medical group of more than 4,800 employed physicians and advanced care providers, a health plan division called Select Health with more than one million members, and other health services. Helping people live the healthiest lives possible, Intermountain is widely recognized as a leader in clinical quality improvement and efficient healthcare delivery. Join our world-class team and embark on a career filled with opportunities, strength, innovation, and fulfillment. To find out more about us, head to our career site here. Sign up for job alerts! Click ‘sign in’ at the top right corner, create a candidate account, and when we have opportunities that meet your interests, you will receive an email with the job details. Intermountain Health strives to make the application process accessible to all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact 1-800-843-7820 or email recruitment@imail.org. This contact information is for accommodation requests only and cannot be used to inquire about the status of applications. Introduce yourself to our Talent Acquisition team and we will get in touch if there is a role that seems like a good match. Intermountain Health’s PEAK program supports caregivers in the pursuit of their education goals and career aspirations by providing up-front tuition coverage paid directly to the academic institution. The program offers 100+ learning options to choose from, including undergraduate studies, high school diplomas, and professional skills and certificates. Caregivers are eligible to participate in PEAK on day 1 of employment. Learn more. The primary intent of this job description is to set a fair and equitable rate of pay for this classification. Only those key duties necessary for proper job evaluation and/or labor market analysis have been included. Other duties may be assigned by the supervisor. All positions subject to close without notice. Thanks for your interest in continuing your career with our team!

Responsibilities

The Medical Director leads the achievement of physician review goals, focusing on quality service, improved efficiencies, and expense management. They also participate in the development and implementation of strategic business plans and facilitate organizational change.