Upvote
Downvote
Medical Director, Medicare
Share Job
- Suggest Revision
- We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.
- The Medical Director, Medicare (MDM) provides organizational leadership in the Population Health (PH) Medicare Line of Business (LOB) under the direction of the Medicare (MC) CMO, in areas such as care management, utilization management/medical cost, quality results, provider performance and policy, to advance ACFC and Medicare Plan objectives and improve the health of our member population.
- The MDM serves as the lead physician to guide care management, define, and achieve quality outcomes, manages day-to-day aspects of PH Medicare functions, and acts as a subject matter expert to other areas.
- Analyzes information to develop interventions that improve quality of care and outcomes, with a focus on at risk performance (ex: STARS, State-based programs, VBC, MOC).
- Provides clinical guidance to CM including MOC, member case reviews as needed and as required in MMP, DSNP and LTSS. Documents and pre-reviews plans.
Expired 8 days agoInactive Job
Similar Job
Relevance
Active