Family Practice Physician Traditional Practitioner - Physicians Only Apply - Perm
Company: Nneka Chinyere Anaebonam
Location: Little Rock
Posted on: September 30, 2024
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Job Description:
A Family Practice Physician Traditional Practitioner practice is
seeking a qualified physician for Little Rock, AR. This and other
physician jobs brought to you by ExactMD. Medical Doctors Only
Apply.
Medical Director (Internal Medicine, Family Practice, Pediatrics or
Emergency Care)
Position Purpose: Assist the CEO to direct and coordinate the
medical management, quality improvement and credentialing functions
for the business unit.
Provides medical leadership of all for utilization management, cost
containment, and medical quality improvement activities. Performs
medical review activities pertaining to utilization review, quality
assurance, and medical review of complex, controversial, or
experimental medical services. Supports effective implementation of
performance improvement initiatives for capitated providers.
Assists CEO in planning and establishing goals and policies to
improve quality and cost-effectiveness of care and service for
members. Provides medical expertise in the operation of approved
quality improvement and utilization management programs in
accordance with regulatory, state, corporate, and accreditation
requirements.
Assists the CEO in the functioning of the physician committees
including committee structure, processes, and membership. Oversees
the activities of physician advisors. Utilizes the services of
medical and pharmacy consultants for reviewing complex cases and
medical necessity appeals. Participates in provider network
development and new market expansion as appropriate. Assists in the
development and implementation of physician education with respect
to clinical issues and policies.
Identifies utilization review studies and evaluates adverse trends
in utilization of medical services, unusual provider practice
patterns, and adequacy of benefit/payment components. Identifies
clinical quality improvement studies to assist in reducing
unwarranted variation in clinical practice in order to improve the
quality and cost of care. Interfaces with physicians and other
providers in order to facilitate implementation of recommendations
to providers that would improve utilization and health care
quality. Reviews claims involving complex, controversial, or
unusual or new services in order to determine medical necessity and
appropriate payment.
Develops alliances with the provider community through the
development and implementation of the medical management programs.
As needed, may represent the business unit before various publics
both locally and nationally on medical philosophy, policies, and
related issues. Represents the business unit at appropriate state
committees and other ad hoc committees
Qualifications:
Education/Experience: Medical Doctor or Doctor of Osteopathy, board
certified preferable in a primary care specialty (Internal
Medicine, Family Practice, Pediatrics or Emergency Medicine). The
candidate must be an actively practicing physician. Previous
experience within a managed care organization is preferred. Course
work in the areas of Health Administration, Health Financing,
Insurance, and/or Personnel Management is preferred. Experience
treating or managing care for a culturally diverse population
preferred.
License/Certifications: Board Certification through American Board
Medical Specialties. Current state medical license without
restrictions.
Keywords: Nneka Chinyere Anaebonam, Little Rock , Family Practice Physician Traditional Practitioner - Physicians Only Apply - Perm, Healthcare , Little Rock, Arkansas
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