Select Health is a not-for-profit community health plan serving more than one million members in the Intermountain west across multiple states and multiple lines of business. Select Health is seeking a part-time medical director within Colorado. Reporting to the Select Health Chief Medical Officer, this Medical Director role is a part-time local Medical Director with a heavily matrixed accountability to the Select Health Market President to aid in local clinical relationships, product and plan performance and to understand local market specifics.
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 Additional Information FTE: 0.2 / 8 hours per week Rate: $159.78 to $181.48 per hour based on relevant experience Eligible for an annual leadership incentive opportunity based on system goals 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.
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.
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. 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 - Lone Tree Work City: Lone Tree Work State: Colorado Scheduled Weekly Hours: 40 The hourly range for this position is listed below.
Actual hourly rate dependent upon experience. $70.00 - $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 . By applying for a position with Intermountain, I acknowledge that I will comply with all applicable Intermountain policies and expectations.
If applying for a remote or hybrid role, this includes remote work expectations related to confidentiality, information security, work schedules, conflicts of interest, and use of company equipment. I further acknowledge that outside employment or activities may not interfere with job responsibilities or create a conflict of interest with Intermountain. Actual or reasonably perceived conflicts may be grounds for disqualification from consideration or, if hired, corrective action up to and including termination of employment.
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