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  • Associate Medical Director

    National Staffing Solutions 4.2company rating

    Forensic medical examiner job in Columbus, OH

    Permanent Associate Medical Director Board Certified in Family Medicine / Internal Medicine FQHC Setting What we Offer: Schedule: M- F 8am to 5pm, No Weekends Competitive Pay: $250k to $270k. depends on experience Sign On Bonus: $30,000 Full Benefits Package - Medical, dental, vision, disability & life insurance. 401(k). What the Associate Medical Director will Do: 80% Clinical / 20% Administration Supervise and coach fellow providers in how to provide excellent primary care / urgent care and community care This is a FQHC setting must be comfortable with Community Medicine Partake in leadership meeting and also act as an ambassador to community based organizations, hospitals, and payers Requirements of the Associate Medical Director: 5+ Years clinical experience / Administrative leadership experience needed Must have 2 -3 recent years experience in primary care medicine Active and unrestricted medical or nursing license in the state required Background in working for a clinic or community based inpatient setting a plus Must be ok prescribing opioids
    $250k-270k yearly 4d ago
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  • Medical Director Physician

    FCS, Inc. 4.8company rating

    Remote forensic medical examiner job

    Full time Psychiatrist to serve as Medical Director in a Dayton-based mental health clinic. Must have experience Board certification preferred. Full time with benefits including 401K match, health, dental, life, PTO, etc. Impressive salary and great hours Monday-Friday. SIGN-ON BONUS. Work remote providing telepsychiatry and conducting internal virtual meetings. Call or email Molly Brown for more information at ext 244 or
    $170k-261k yearly est. 7d ago
  • Physician / Administration / Puerto Rico / Permanent / Medical Director - Medicaid (remote)

    Humana 4.8company rating

    Remote forensic medical examiner job

    Become a part of our caring community and help us put health first The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
    $197k-311k yearly est. 6d ago
  • Associate Medical Officer

    Chenmed

    Forensic medical examiner job in Columbus, OH

    We're unique. You should be, too. We're changing lives every day. For both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts? Do you inspire others with your kindness and joy? We're different than most primary care providers. We're rapidly expanding and we need great people to join our team. The Clinical Director will directly supervise and train primary care providers (PCPs) in his/her assigned center. The incumbent in this role is accountable for maximizing overall core model execution, including improving clinical quality, efficiency, outcomes, and clinician/patient satisfaction. In addition to being accountable for the overall clinical outcomes of his/her assigned center, they will have a portion of their time allocated to direct patient care as a PCP and/or other clinical duties (amount dependent on number of direct reports). The remainder of their time is allocated to leadership responsibilities, including PCP performance, engagement, and building a strong clinical-operations synergy and culture. The allocation of time is dependent on several factors, including PCP capacity, market needs, size of centers, patient membership, and Market Clinical Director direction. ESSENTIAL JOB DUTIES/RESPONSIBILITIES: Independently provides care for patients with acute and chronic illnesses encountered in older adult patients. Takes full accountability for patient care and outcomes and appropriately seeks consultation from specialists when needed, though will still stay involved in, and be responsible for, the detailed care of the patient. Engages with the hospitalist whenever one of their patients is in the hospital (regardless of whether the hospitalist works for ChenMed or not). Responsible for assessment, diagnosis, treatment, management, education, health promotion and care coordination and documentation for patients with acute and complex chronic health needs. Leads their care team consisting of care promoter (medical assistant), care facilitator, and care coordinator for patients able to come to the office. For patients that are unable to come to the office-in hospital, SNF, LTC or homebound, engages with the transitional care team and others including case managers, acute and transitional-care physicians, and other resources that may be available depending on the market. Leads Super Huddle (SH) and Transforming Care Meeting (TCM) weekly, as well as supports Center Manager/Center General Manager center clinical leader and/or market clinical leader is not available, based on guidance from Market Chief Medical Officer. Fills in as needed for center clinical leadership needs, including monitoring daily center census as part of joint center accountability for outcomes. Plays an active role in the management of their center and helps cover for other providers who may be out for various reasons. It is also expected that each Clinical Director will take an active role as needed in recruiting patients for the center and recruiting and interviewing additional providers for the company. Managing, mentoring and coaching PCPs in his/her assigned center to deliver outstanding clinical outcomes, including sampling other PCP's daily huddles within their center Leadership rounding with the PCPs (reduced involvement of market clinical leader) Partnering with Center Operations Director/Market General Manager to drive continued improvement of center financial performance, and helping increase center membership Performs other duties as assigned and modified at manager's discretion. KNOWLEDGE, SKILLS AND ABILITIES: Proficient in Microsoft Office Suite products including Word, Excel, PowerPoint and Outlook, plus a variety of other applications used in the company Ability and willingness to travel locally as needed in their market, if applicable, nationally for initial training (2 weeks) and then occasionally regionally and nationally for recruiting or training purposes Fluency in English, verbal and written. There may be jobs in some centers that require fluency in other languages, and this will be made known at the time of application. This job requires use and exercise of independent judgment EDUCATION AND EXPERIENCE CRITERIA: MD or DO in Internal Medicine, Family Medicine, Geriatrics, or similar specialty required Current, active MD licensure in State of employment is required A minimum of 1-year clinical experience in geriatric, adult or family practice setting preferred, with Lead PCP ideally being a ChenMed PCP Partner Completion of Chen Medical training, including Masterful Conversations and meeting facilitation, as part of the individual development plan Board certification in Internal Medicine, Family Medicine, Geriatrics or similar specialty is preferred, Board Eligibility is required Once Board certified, PCP will maintain board certification in their terminal specialty by doing necessary MOC, CME and/or retaking board exams as required Must have a current DEA number for schedule II-V controlled substances Basic Life Support (BLS) certification from the American Heart Association (AMA) or American Red Cross required w/in first 90 days of employment PAY RANGE: $238,832 - $341,189 Salary EMPLOYEE BENEFITS We're ChenMed and we're transforming healthcare for seniors and changing America's healthcare for the better. Family-owned and physician-led, our unique approach allows us to improve the health and well-being of the populations we serve. We're growing rapidly as we seek to rescue more and more seniors from inadequate health care. ChenMed is changing lives for the people we serve and the people we hire. With great compensation, comprehensive benefits, career development and advancement opportunities and so much more, our employees enjoy great work-life balance and opportunities to grow. Join our team who make a difference in people's lives every single day. Current Employee apply HERE Current Contingent Worker please see job aid HERE to apply #LI-Onsite
    $238.8k-341.2k yearly 6d ago
  • Medical Director

    Intepros

    Remote forensic medical examiner job

    Medical Director (Utilization Management) The Medical Director plays a key role in ensuring coverage and payment determinations are clinically appropriate, compliant, and aligned with plan benefits and contractual agreements with participating provider networks. This position requires sound clinical judgment, collaborative leadership, and a strong understanding of healthcare delivery, population health, and payer operations. Key Responsibilities Provide physician leadership and clinical guidance to Utilization Management and Care Management functions Render coverage and payment determinations in accordance with health plan benefits, medical policies, and provider contracts Apply evidence-based clinical guidelines and best practices to support consistent, high-quality decision-making Exercise informed medical judgment grounded in clinical medicine, patient safety, quality management, and population health principles Collaborate effectively with clinical teams, operational leaders, senior management, and external partners Promote efficient, cost-effective care delivery across all lines of business Support organizational initiatives related to quality improvement, compliance, and healthcare outcomes Required Qualifications & Experience Medical Doctor (MD) or Doctor of Osteopathy (DO) from an accredited medical or osteopathic medical school recognized by AAMC, AOA, or WHO Unrestricted and active Pennsylvania medical or osteopathic license Current board certification through ABMS or AOBMS (Family Medicine or Internal Medicine preferred) Ability to successfully complete organizational credentialing requirements Strong knowledge of Utilization Management, healthcare delivery systems, and payer-based medical decision-making Work Location Fully Remote: This position is designated as fully remote Work must be performed within the Tri-State Area (Pennsylvania, New Jersey, or Delaware)
    $181k-282k yearly est. 2d ago
  • Medical Director - Anesthesiology - $150K Sign On Bonus! - Mount Carmel Dublin

    Vituity

    Forensic medical examiner job in Dublin, OH

    $150K Sign On Bonus - Dublin, OH - Seeking Anesthesiology Medical Director Join the Physician Partnership Where You Can Increase Your Impact Vituity's ownership model provides autonomy, local control, and a national system of support, so you can focus your attention where you want it to be - on your patients. Join the Vituity Team. Vituity is a 100% physician-owned partnership and is led by frontline physicians that are all equitable owners. As an equal and valued partner from day one, our ownership model provides you with financial transparency, a comprehensive benefits package including profit distribution, and multiple career development opportunities. Our leadership understands what your practice needs to thrive and gives you autonomy and local control so you can provide care when, where, and how your patients need it. You are backed by a best-in-class corporate healthcare team and supported by the broad peer-level expertise of 6,000 Vituity clinicians. At Vituity we've cultivated an environment where passion thrives, and success comes through shared purpose. We were founded in a culture that values team accomplishments more than individual achievements, an approach we call “culture of brilliance.” Together, we leverage our strengths and experiences to make a positive impact in our local communities. We foster this through shared goals and helping our colleagues succeed, and we also understand the importance of recognition, taking the time to show appreciation and gratitude for a job well done. Vituity Locations: Vituity has opportunities at 475 sites across the country, serving 9 million patients a year. With Vituity, if you ever need to move, you can take your job with you. The Opportunity $150k sign-on bonus for qualified candidates! Communicate and champion Vituity's purpose, mission, vision, values, culture of brilliance, and strategy, ensuring widespread understanding and alignment. Assure compliance with all Vituity requirements and policies and communicate those requirements to all Vituity providers. Monitor current and future healthcare and economic trends. Assess their potential impact on the practice and local geographic region. Strategize and execute a comprehensive annual practice management plan that sets clear goals and objectives, continuously surpassing expectations and delivering value to patients, clients, providers, and the local community. Spearhead the local site's administrative management team, meticulously selecting team members and aligning their responsibilities to drive the achievement of practice goals. Demonstrate unwavering mastery of Vituity policies and fiduciary obligations, ensuring strict adherence from all providers. Exemplify Vituity's Partnership Principles by fostering open communication and transparent decision-making, such as conducting annual reviews of administrative stipends and scheduling preferences. Demonstrate a comprehensive understanding of hospital expectations and rigorously uphold compliance with all contract terms. Monitor operational and quality metrics and implement Vituity initiatives and operational programs to continually improve performance. Continuously assess and improve operational processes, leveraging technology and best practices to streamline workflows and increase efficiency. Monitor site financial performance and identify and create new areas for growth and revenue. Develop an expertise and understanding of the yearly budget, financial performance measures and monitoring systems, and billing and reimbursement issues / systems. Improve patient census and billing practice statistics to optimize reimbursement for the practice. Maintain awareness and interactions with payers such as significant IPA's, Medical Groups, Foundations, ACO's associated with the hospital / health system. Execute efficient recruitment, onboarding, and training processes for new providers, ensuring the practice is staffed with highly qualified professionals. Provide learning and development opportunities and mentoring to providers and staff to enhance their clinical acumen, leadership skills and overall professional growth. Evaluate the performance of physicians and PA / NPs in compliance with Vituity policies and guidelines. Monitor physician competencies with progressive improvement using appropriate metrics. Counsel, suspend, or remove staff from the schedule as necessary in compliance with Vituity polices / guidelines. Actively participate in contract negotiations in conjunction with the Regional Director. Develop, foster, and maintain productive and collaborative working relationships with hospital leadership, nursing staff and other healthcare team members. Ensure practice is appropriately represented and demonstrates their value through leadership roles (as applicable) and/or participation with hospital management, medical staff leadership, Medical Executive, Medical Staff, and other hospital committees, and within the local community. Required Experience and Competencies Licensed physician as a Medical Doctor (M.D.) or Doctor of Osteopathic Medicine (D.O.) degree from an accredited medical school and completion of residency through an accredited residency program required. Maintain membership and privileges on Hospital's medical staff and comply with and abide by the bylaws, rules and regulations, and the policies and procedures of Hospital's medical staff where services are being provided required. Physician Partnership status required. 5 years or more experience in a leadership role required. Verbal and written communication skills. Superior clinical skills. Interpersonal and leadership skills. Ability to motivate a team. Project Management. Effectively collaborate with diverse individuals and multiple locations. Relationship building. Technical skills. Strong accounting and finance understanding. The Practice Mount Carmel Dublin, Surgical Hospital - Dublin, Ohio 30-bed brand new, state-of-the-art facility with 4 ORs. No call with daily hours in between 7am-5pm. 2,500 predicted annual cases. The Community Dublin, Ohio, is a charming city combining small-town appeal with modern amenities, making it an ideal place to work and call home. Located just outside Columbus, Dublin offers a vibrant community and a robust job market, particularly in healthcare and technology. The city is renowned for its scenic beauty, with landmarks like Indian Run Falls and the Dublin Link, a striking pedestrian bridge. Residents enjoy outdoor activities at Glacier Ridge Metro Park and events like the Dublin Irish Festival, one of the largest in the country. Dublin experiences four distinct seasons, with warm summers and snowy winters. Its proximity to Columbus provides access to cultural attractions, shopping, and sports events, including Ohio State University athletics. Known for its excellent schools, well-planned neighborhoods, and strong community spirit, Dublin offers a high quality of life for families and professionals alike. Benefits & Beyond* Vituity cares about the whole you. With our comprehensive compensation and benefits package, we are mindful of what matters most, and support your needs of today and your plans for the future. Superior Health Plan Options Dental, Vision, HSA, life and AD&D coverage, and more Partnership models allows a K-1 status pay structure, allowing high tax deductions Extraordinary 401K Plan with high tax reduction and faster balance growth Eligible to receive an Annual Profit Distribution/yearly cash bonus EAP, travel assistance, and identify theft included Student loan refinancing discounts Purpose-driven culture focused on improving the lives of our patients, communities, and employees We are unified around the common purpose of transforming healthcare to improve lives and we believe everyone has a role to play in that. When we work together across sites and specialties as an integrated healthcare team, we exceed the expectations of our patients and the hospitals and clinics we work in. If you are looking to make a difference, from clinical to corporate, Vituity is the place to do it. Come grow with us. Vituity does not discriminate against any person on the basis of race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information (including family medical history), veteran status, marital status, pregnancy or related condition, or any other basis protected by law. Vituity is committed to complying with all applicable national, state and local laws pertaining to nondiscrimination and equal opportunity. *Visa status applicants benefits vary. Please speak to a recruiter for more details. Applicants only. No agencies please.
    $177k-281k yearly est. 2d ago
  • Chief Medical Officer

    Health Plan of San Joaquin/Mountain Valley Health Plan 4.6company rating

    Remote forensic medical examiner job

    The Health Plan of San Joaquin is now hiring an experienced and dedicated Chief Medical Officer to continuously improve the health of our community! Remote: This is a remote position but must be able to attend monthly onsite meetings, and as needed for business and community purposes. As our Chief Medical Officer, under administrative direction, you will be responsible for leading efforts that will provide innovative solutions that support more affordable healthcare, promote personal accountability for health and wellness, and offer superior service and partnerships to the constituents served by HPSJ! Supervises: Medical Directors Director of Pharmacy Director of Clinical Analytics Executive Assistant Essential Functions: Identifies, develops, plans and executes short, medium and long-range strategies that drive and support corporate objectives; ensures the development and implementation of associated business plans, tactics and policies. Develops and oversees the implementation of medical management policies. Ensures that medical decisions are rendered by qualified medical personnel and are not influenced by fiscal or administrative management considerations. In collaboration with the Chief Heath Services Officer, will ensure consistent application of medical criteria to utilization management decision making. Collaborates with the Chief Health Services Officer in the strategic planning, implementation and oversight of the Quality Improvement and Quality Management Programs. Ensures that medical care provided meets acceptable medical care standards. Ensures that medical protocols and rules of conduct for HPSJ medical personnel are followed. Manages medical utilization through application of recognized medical and pharmaceutical guidelines and in collaboration internal and external stakeholders. Oversees the development and management of department budgets. Oversees accreditation and compliance activities to ensure agreed upon and mandated standards are met. In collaboration with the Chief Heath Services Officer, will identify medical delivery system quality issues; develops and oversees implementation of corrective action plans. Collaborates with network providers and the provider community in a manner that engenders positive relationships, provider support and network stability. Advises on complex, controversial and/or unique claims that are outside the realm of medical policy. Co-Chairs the Quality Improvement and Health Equity Transformation Committee and Chairs the Peer Review and Credentialing committee; serve on other committees as required. Ensures that effective collaborative work and problem-solving routines are maintained between assigned departments, and other internal and external stakeholders. Oversees the identification, preparation and maintenance of appropriate and required data, records and reports. Represents HPSJ in a manner that promotes a positive image of HPSJ in the community; serves on internal and external committees and other leadership forums. Promotes and maintains and ensures that direct reports promote and maintain an environment that supports HPSJ's strategy, vision, mission and values. Hires, develops and retains, and ensures that line managers hire, develop and retain, a competent staff. What You Bring: Knowledge, Skills, Abilities and Competencies Required Expert knowledge of the principles, practices and techniques of managed care, utilization management and quality. Knowledge of laws and regulations governing managed care. Expert knowledge of contemporary health issues, and the healthcare, economic or other issues affecting Medi-Cal and/or Medicare populations, providers and the underserved in San Joaquin and surrounding areas. Knowledge of quality improvement and utilization management procedures and techniques. Knowledge of the management and best practices techniques of a medical practice or office. Strategic mindset: Sees ahead to future possibilities and translates them into breakthrough strategies; identifies, plans, leads and executes meet changing organizational and community needs, and regulatory requirements. Cultivates innovation: Creates new and better ways for the organization to be successful. Drives results: Consistently achieves results, even under tough circumstances. Drives engagement: Creates a climate where people are motivated to do their best to help the organization achieve its objectives. Drives vision and purpose: Paints a compelling picture of the vision and strategy that motivates others to action. Courage: Steps up to address difficult issues, says what needs to be said. Nimble learning: Actively learns through experimentation when tackling new problems, uses both successes and failures as learning fodder. Situational adaptability: Adapts approach and demeanor in real time to match the shifting demands of different situations. Uses Lean, Performance Improvement, Return on Investment and metrics to successfully manage the division. Strong skills in budget development and management. Communicates effectively: Develops and delivers multi-mode communications that convey a clear understanding of the unique needs of different audiences. Strong presentation skills, including the ability to tailor presentations to a specific audience, and address and interact with large groups. Very strong interpersonal skills, with the ability to establish and maintain effective working relationships with individuals at all levels inside and outside of HPSJ. Strong assessment and analytical skills, including the ability to synthesize, distill concepts, draw conclusions and identify implications. Manages complexity: Makes sense of complex, high quantity, and sometimes contradictory information to effectively solve problems. Resourcefulness: Secures and deploys resources effectively and efficiently; organizes people and resources to solve problems and identify opportunities. Plans and aligns: Plans and prioritizes work for self and others to meet commitments aligned with organization goals. Very strong project management skills, with the ability to function as a sponsor and owner on complex projects; a track record of successful large project implementations. Very strong collaboration skills with demonstrated ability to create and foster a collaborative work environment, maintain effective, high-performance teams, and organize people and resources to solve problems and identify business opportunities. Strong customer service skills. Ensures accountability: Holds self and others accountable to meet commitments. Strong knowledge of change management theory, with ability to anticipate and implement effectively. Promotes and maintains and ensures that direct reports promote and maintain an environment that supports HPSJ's strategy, vision, mission and values. Very strong coaching/counseling skills, including the ability to function as a mentor to management and employees by assisting in the identification and resolution of issues. Demonstrated ability to supervise staff in a manner that maximizes employee performance and business results. Education and Experience Required MD degree from an accredited medical school. Satisfactory completion of an American Council of Graduate Medical Education accredited residency program; and At least ten years clinical experience in the practice of medicine in fields related to a managed care setting; and At least five years clinical experience in the practice of medicine with MediCal and/or Medicare populations; or Equivalent combination of education and experience. Licenses, Certifications Required Unrestricted, active license to practice medicine in the State of California, issued by the State Board of Medical Examiners, which meets the Health Plan's credentialing and recredentialing requirements. Board Certification in a medical specialty; and Satisfactory completion of an American Council of Graduate Medical Education accredited residency program. We are an equal opportunity employer and diversity is one of our core values. We believe that differences including race, ethnicity, gender, sexual orientation, and other characteristics, will help us create a strong organization that is sensitive to the needs of those we serve. Employment decisions are made on the basis of qualifications and merit. HPSJ provides equal employment opportunities to employees and applicants for employment and prohibits discrimination based on color, race, gender (including gender identity and gender expression), religion (including religious dress and grooming practices), marital status, registered domestic partner status, age, national origin (including language use) or ancestry, physical or mental disability, medical condition (including cancer and genetic characteristics), sex (including pregnancy, childbirth, breastfeeding or related medical condition), genetic information, sexual orientation, military or veteran status, political affiliation or any other characteristic made unlawful by applicable Federal, State or local laws. It also prohibits unlawful discrimination based on the perception that anyone has these characteristics or is associated with anyone who has or is perceived to have these characteristics.
    $224k-322k yearly est. 3d ago
  • Director, Medical Affairs (Remote)

    Stryker Corporation 4.7company rating

    Remote forensic medical examiner job

    Abbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 114,000 colleagues serve people in more than 160 countries. Working at Abbott At Abbott, you can do work that matters, grow, and learn, care for yourself and your family, be your true self, and live a full life. You'll also have access to: Career development with an international company where you can grow the career you dream of. Employees can qualify for free medical coverage in our Health Investment Plan (HIP) PPO medical plan in the next calendar year. An excellent retirement savings plan with high employer contribution Tuition reimbursement, the Freedom 2 Save student debt program and FreeU education benefit - an affordable and convenient path to getting a bachelor's degree A company recognized as a great place to work in dozens of countries around the world and named one of the most admired companies in the world by Fortune. A company that is recognized as one of the best big companies to work for as well as a best place to work for diversity, working mothers, female executives, and scientists. The Opportunity Abbott Heart Failure (HF) delivers devices for patients living with heart failure in the areas of hemodynamic monitoring and mechanical circulatory support. Medical affairs of Abbott HF is seeking to hire a director who will join a team of medical specialist dedicated to all medical aspects of safe and effective device heart failure treatment. The director will report to the Chief Medical Officer. The Director of Medical Affairs will provide daily business operations support related to product development and clinical research, product quality, compliance, commercial/marketing activities and customer interactions. The director assists the Chief Medical Officer in being medical representative of Abbott HF to external regulatory agencies and professional societies. What You'll Work On The Medical Director Develops medical opinions, medical platform documents and Health Hazard Assessments. Provides medical input for promotional and commercial activities as requested. Serves as medical representative on Risk Evaluation teams. Assists investigation teams by providing medical input as needed. Responsible for updating medical affairs procedural documents and submitting change requests when needed. Provides medical support for MDR reporting when needed. Provides initial medical input for quality/regulatory customer communications, technical bulletins and quality directives. Engages with direct customer interactions with medical content as needed. Regionally responsible for Investigator Initiated Study and Research Grant programs. Provides input or content to professional education activities. Responsible for engaging in and documenting off-label discussions. Assists the Chief Medical Officer in KOL and professional society engagement. Provides medical input to new product development An MD is strongly preferred for this role, but a PhD in a relevant area would be considered. A minimum of 5 years of clinical experience including in CV medicine would be clinical research, including interpretation and presentation would be expected. Strong presentation skills required. The role is remote (US-based) Up to 70 % travel should be expected. APPLY NOW Enjoy a competitive base salary plus exciting bonus opportunities and long-term incentives designed to recognize your success. Learn more about our health and wellness benefits, which provide the security to help you and your family live full lives: ********************** Follow your career aspirations to Abbott for diverse opportunities with a company that can help you build your future and live your best life. Abbott is an Equal Opportunity Employer, committed to employee diversity. Connect with us at *************** on Facebook at *********************** and on Twitter @AbbottNews and @AbbottGlobal #J-18808-Ljbffr
    $221k-314k yearly est. 5d ago
  • Remote Liver Medical Affairs Director - Regional Expert

    Gilead Sciences, Inc. 4.5company rating

    Remote forensic medical examiner job

    A leading biopharmaceutical company is seeking a Senior Director for Medical Affairs to lead initiatives focused on liver diseases. The ideal candidate should have substantial clinical experience in hepatology and a commitment to scientific excellence. This remote position requires strategic collaboration and contributions to research efforts to improve liver care outcomes. Strong leadership and communication skills are essential for engaging diverse healthcare professionals in clinical discussions. #J-18808-Ljbffr
    $235k-330k yearly est. 1d ago
  • Morning Remote Emergency Radiologist - Renaissance Imaging Medical Associates

    Radiology Partners 4.3company rating

    Remote forensic medical examiner job

    RIMA, a Radiology Partners practice, is looking for a high quality radiologist to fill a full-time Remote Reader position in our practice. This position will interpret primarily emergency imaging. Candidates must be residency-trained in Diagnostic Radiology and share a vision for an integrative and collaborative care model with a multi-disciplinary team. We have a commitment to quality and ardently promote and invest in the professional development of our radiologists through quality and leadership programs. Candidates must be residency-trained in Diagnostic Radiology and Board-Certified or Board-Eligible in Diagnostic Radiology. Ability to interpret general and advanced emergency radiology studies is required. We offer highly competitive compensation with an opportunity for partnership, as well as competitive salary and benefits including malpractice insurance coverage, 401K, CME discounts, disability coverage and healthcare reimbursement. POSITION DUTIES AND RESPONSIBILITIES * 7 days on and 7 days off (5am EST-2pm EST) "END Time is Negotiable" * Remote reading from home * Interpret emergency (STAT ER, urgent care and inpatient) imaging for several facilities in our practice * Work 26 weeks and enjoy 26 weeks off * Partnership track position DESIRED PROFESSIONAL SKILLS AND EXPERIENCE * Candidates must be a Doctor of Medicine or Osteopathy, Board-certified/Eligible in the practice of Diagnostic Radiology * Current California licensure is preferred, ultimately required for the position * Neuroradiology fellowship preferred * Fellowship trained in Neuro, Emergency Radiology, body, MSK, or Pediatrics is preferred COMPENSATION: The salary for this position is $600,000. Final determinations may vary based on several factors including but not limited to education, work experience, certifications, geographic location etc. This role is also eligible for an annual discretionary bonus. In addition to this range, Radiology Partners offers competitive total rewards packages, which include health & wellness coverage options, 401k benefits, and a broad range of other benefits such as family planning and telehealth (all benefits are subject to eligibility requirements). FOR MORE INFORMATION OR TO APPLY For inquiries about this position, please contact Misha Hepner at ************************** or ************. PRACTICE OVERVIEW Radiology Partners, through its affiliated practices, is a leading radiology practice in the U.S., serving hospitals and other healthcare facilities across the nation. As a physician-led and physician-owned practice, we advance our bold mission by innovating across clinical value, technology, service and economics, while elevating the role of radiology and radiologists in healthcare. Using a proven healthcare services model, Radiology Partners provides consistent, high-quality care to patients, while delivering enhanced value to the hospitals, clinics, imaging centers and referring physicians we serve. Radiology Partners is an equal opportunity employer. RP is committed to being an inclusive, safe and welcoming environment where everyone has equal access and equitable resources to reach their full potential. We are united by our Mission to Transform Radiology and in turn have an important impact on the patients we serve and the healthcare system over all. We hold that diversity is a key source of strength from which we will build a practice culture that is inclusive for all. Our goal is to empower and engage the voice of every teammate to promote awareness, compassion and a healthy respect for differences. CCPA Notice: When you submit a job application or resume, you are providing the Practice with the following categories of personal information that the Practice will use for the purpose of evaluating your candidacy for employment: (1) Personal Identifiers; and (2) Education and Employment History. Radiology Partners participates in E-verify. Beware of Fraudulent Messages: Radiology Partners will never request payment, banking, financial or personal information such as a driver's license in exchange for interviews or as part of the hiring process. Additionally, we will not send checks for deposit into your bank account at any stage of recruitment. All communication during the interview and hiring process should come from an email address ending in "@radpartners.com." If you suspect you are receiving a fraudulent job offer or solicitation from Radiology Partners or one of our local practices, please notify our Recruiting Team at **************************.
    $173k-316k yearly est. 60d+ ago
  • Health Plan Medical Director

    Massachusetts Eye and Ear Infirmary 4.4company rating

    Remote forensic medical examiner job

    Site: Mass General Brigham Health Plan Holding Company, Inc. Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. Job Summary Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are on the forefront of transformation with one of the world's leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage. Our work centers on creating an exceptional member experience - a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a consciously inclusive environment where diversity is celebrated. We are pleased to offer competitive salaries, and a benefits package with flexible work options, career growth opportunities, and much more. Under the direction of the Senior Medical Director, the Medical Director leads as a senior physician at the health plan. This position works closely with the Senior Medical Director in providing medical management leadership for clinical services operations and programs. This role focuses on and has expertise in utilization management, health plan quality and accreditation, care management, and other health plan functions. Qualifications Licensure and Credentials: Must maintain an active full physician license in Massachusetts Experience: 3-5 years of Health Plan experience at least 5 years of clinical practice experience Job Duties: Handles utilization management initial determinations, appeals and grievances within the scope of their expertise as defined by Medicare, MassHealth, NCQA and the Division of Insurance and within the compliance requirements of key regulatory and accreditation entities •Reviews clinical services and quality incidents when sufficiently serious to merit physician involvement •Coverage of medical necessity determinations to support special investigations/fraud waste and abuse cases •Collaborates on health plan medical policy development •Assesses new, emerging, and existing technologies to determine appropriateness of health plan coverage •Partners with clinical leaders to ensure medical service expenditures remain within budget •Collaborates with business development, quality, finance and medical management teams to promote improvements in the quality and cost efficiency of care throughout the MGB Health Plan provider network •Delivers consultation to network management staff and deployment of education programs for network clinicians •Develops and delivers presentations for clinical staff on current topics relevant to MGB Health Plan members and network •May represent MGB Health Plan at a variety of external forums and committees •Interact, communicate and collaborate with network and community physicians, hospital leaders and other vendors regarding care and services for enrollees •Monitors performance metrics and audits to identify areas for continuous improvement and ensure compliance •Anticipates and meets or exceeds internal and/or external customer expectations and requirements; establishes and maintains positive relationships with customers and gains their trust and respect •Build strong relationships and infrastructure that designate MGB Health Plan as a people-first organization •Ensure diversity, equity and inclusion are integrated as a guiding principle •Other duties as assigned with or without accommodation Additional Job Details (if applicable) Primarily remote position, exempt •In person meetings as requested for business needs •Participates in after hours and weekend call rotation as assigned Remote Type Remote Work Location 399 Revolution Drive Scheduled Weekly Hours 40 Employee Type Regular Work Shift Day (United States of America) EEO Statement: Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at **************. Mass General Brigham Competency Framework At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.
    $206k-287k yearly est. Auto-Apply 35d ago
  • Medical Director, Cardiometabolic Clinical Care Model Design and Client Engagement

    Teladoc Health Medical Group 4.7company rating

    Remote forensic medical examiner job

    Join the team leading the next evolution of virtual care. At Teladoc Health, you are empowered to bring your true self to work while helping millions of people live their healthiest lives. Here you will be part of a high-performance culture where colleagues embrace challenges, drive transformative solutions, and create opportunities for growth. Together, we're transforming how better health happens. Summary of Position Teladoc Health is seeking an experienced physician to serve as Medical Director, Cardiometabolic Clinical Care Model Design and Client Engagement. This physician leader will serve in a highly cross-functional role instrumental in shaping the future of cardiometabolic care at Teladoc Health, particularly within our U.S. Group Health Business, advancing clinical excellence across existing chronic condition management solutions while building and scaling novel approaches. This role will continue to champion seamless integration of cardiometabolic care across our expansive ecosystem of virtual primary care, urgent care, mental health, expert medical/specialty care, and more. This is an individual contributor leadership position requiring strong clinical expertise in cardiometabolic care and the ability to work strategically in the complex and rapidly evolving virtual care/digital health space. Success in this role requires close cross-functional collaboration with diverse stakeholders to enhance care delivery models, achieve best-in-class clinical outcomes, and optimize return on investment. The candidate will support value-based care partnerships and drive clinical research to strengthen the evidence base for virtual cardiometabolic care. Additionally, this physician leader must be able to translate these efforts into client-facing strategies, partnering with employers and payers to help them understand and achieve better health outcomes for their populations. Essential Duties and Responsibilities Serve as the clinical lead for designing cardiometabolic care models across new and existing capabilities within the U.S. Group Health business. Lead clinical and cross-functional teams to design, pilot, and scale innovative integrated cardiometabolic care models, working closely with front-line providers and care teams. Translate population health data and risk stratification into actionable program strategies. Define success metrics-including clinical outcomes and financial ROI-and develop strategies for sustained impact. Work closely with internal teams-including sales, marketing, and client-facing groups-providing clinical expertise for key presentations and client discussions. Represent the organization externally on topics related to chronic condition management and cardiometabolic care innovation. Develop and refine chronic condition management frameworks, measures, and reporting aligned with the Institute for Healthcare Improvement Quadruple Aim and Institute of Medicine quality domains: safety, effectiveness, patient-centeredness, efficiency, timeliness, and equity. Co-lead formal quality improvement projects using the Model for Improvement with a focus on process and outcome metrics and leveraging statistical process control (SPC) where appropriate. Partner with our Clinical Research team to generate evidence and insights for white papers and peer-reviewed publications demonstrating the impact of our cardiometabolic solutions. The time spent on each responsibility reflects an estimate and is subject to change dependent on business needs. Supervisory Responsibilities No Required Qualifications MD/DO in Internal Medicine, Family Medicine, or a cardiometabolic specialty; active medical license preferred At least 5+ years of post-residency or fellowship clinical experience Experience in virtual care, digital health, or healthcare technology, with the ability to adapt to rapid change and ambiguity. Demonstrated expertise in delivering evidence-based clinical care model design, clinical quality improvement, outcome measurement. Exemplary written and verbal communication skills, including the ability to explain complex clinical concepts to non-clinical audiences. Proven ability to collaborate effectively across clinical and non-clinical teams, including operations, product, engineering, marketing, commercial, and other functions in a highly matrixed environment. Strong prioritization, time management, and organizational skills, with meticulous attention to detail. Ability to thrive in fast-paced, dynamic environments with multiple competing priorities and deadlines. Preferred Qualifications Experience in dedicated virtual care/digital health organizations focused on cardiometabolic conditions. MBA/MPH and/or advanced quality improvement training preferred. Demonstrated experience delivering virtual care, particularly in primary care and cardiometabolic management beyond the COVID-19 pandemic. Expertise in value-based care delivery with track record of maximizing clinical outcomes while managing total cost of care. Required license or credential needed to perform job: MD/DO The above qualifications, knowledge, experience, and/or background are expected but not required for this role. Work Environment ☐ Office ☒ Remote ☐ Hybrid (Office & Remote) Travel: ≥10% Travel percentage reflects an estimate and is subject to change dependent on business needs. The base salary range for this position is $210,000 - $240,000. In addition to a base salary, this position is eligible for a performance bonus and benefits (subject to eligibility requirements) listed here: Teladoc Health Benefits 2026. Total compensation is based on several factors including, but not limited to, type of position, location, education level, work experience, and certifications. This information is applicable for all full-time positions. As part of our hiring process, we verify identity and credentials, conduct interviews (live or video), and screen for fraud or misrepresentation. Applicants who falsify information will be disqualified. Teladoc Health will not sponsor or transfer employment work visas for this position. Applicants must be currently authorized to work in the United States without the need for visa sponsorship now or in the future. Why join Teladoc Health? Teladoc Health is transforming how better health happens. Learn how when you join us in pursuit of our impactful mission. Chart your career path with meaningful opportunities that empower you to grow, lead, and make a difference. Join a multi-faceted community that celebrates each colleague's unique perspective and is focused on continually improving, each and every day. Contribute to an innovative culture where fresh ideas are valued as we increase access to care in new ways. Enjoy an inclusive benefits program centered around you and your family, with tailored programs that address your unique needs. Explore candidate resources with tips and tricks from Teladoc Health recruiters and learn more about our company culture by exploring #TeamTeladocHealth on LinkedIn. As an Equal Opportunity Employer, we never have and never will discriminate against any job candidate or employee due to age, race, religion, color, ethnicity, national origin, gender, gender identity/expression, sexual orientation, membership in an employee organization, medical condition, family history, genetic information, veteran status, marital status, parental status, or pregnancy). In our innovative and inclusive workplace, we prohibit discrimination and harassment of any kind. Teladoc Health respects your privacy and is committed to maintaining the confidentiality and security of your personal information. In furtherance of your employment relationship with Teladoc Health, we collect personal information responsibly and in accordance with applicable data privacy laws, including but not limited to, the California Consumer Privacy Act (CCPA). Personal information is defined as: Any information or set of information relating to you, including (a) all information that identifies you or could reasonably be used to identify you, and (b) all information that any applicable law treats as personal information. Teladoc Health's Notice of Privacy Practices for U.S. Employees' Personal information is available at this link .
    $210k-240k yearly Auto-Apply 4d ago
  • Regional Medical Affairs Director - Gulf Coast

    Xeris Pharmaceuticals 4.2company rating

    Remote forensic medical examiner job

    The Regional Medical Affairs Director (RMAD) is a member of a field-based team which is an extension of the US Regional Medical Affairs organization and is responsible for developing and enhancing professional relationships with specified key thought-leaders (KTLs), institutions, and organizations in their assigned geographical region. A RMAD focuses on medical & scientific engagement with identified healthcare and decision maker stakeholders by providing medical and scientific support via scientific exchange, addressing customers medical and scientific informational needs, and collaborating in mutually identified areas of medical, education, clinical research, and real-world experience/evidence. RMADs are recognized as an internal subject matter expert and provide appropriate medical and scientific support for internal teams as identified. Candidate to reside in: Houston, TX; San Antonio, TX; New Orleans, LA; or Jackson, MS Territory covers: TX, LA, MS Responsibilities Fostering mutually collaborative relationships with institutions, Centers of Excellence, thought leaders (TLs) and key decision makers across the healthcare ecosystem in the areas of medical, education, clinical research, and real world experience. Provide medical information through scientific exchange in a fair-balanced manner and clinical/scientific support as identified or requested in addressing the informational needs of the healthcare community, as well as responding to unsolicited requests for pipeline or off-label information. Delivering medical presentations to diverse healthcare professional (HCP) audiences including healthcare decision makers, professional medical societies, and identified advocacy groups. Providing scientific and liaison support related to Xeris clinical research activity, including thought leader and investigator engagement and follow-up, and facilitation of unsolicited requests for interactions related to Investigator Initiated Studies (IISs). Maintaining cross-functional collaboration with internal & external field teams to provide scientific expertise and medical support within Medical Affairs, Clinical Development, Commercial, and other internal stakeholders, etc. Obtaining, assimilating, organizing, and reporting appropriate competitive and scientific intelligence in a concise, clear manner, compliant with all applicable Xeris policies, procedures, and processes Attending & participating in medical/scientific meetings and conferences for the purpose of gaining scientific insights, collecting emerging scientific data, identifying healthcare trends, and supporting the scientific exchange and communication related to Xeris therapeutic areas of interest and research & development As identified, contribute to internal training for headquarter- and field-based teams and supporting speaker training initiatives. Assisting with the implementation and engagement of TL participation in advisory boards, consultant meetings and other scientific meetings consistent with all Xeris policies, procedures, and processes. Maintain clinical/scientific expertise and providing strategic insights into emerging scientific data and healthcare trends. Collaborating with TLs and Xeris Medical Communications to support the development of appropriate publications and related medical communications. Participate in assigned Medical Affairs projects, initiatives, and activities as identified and requested. Performing and completing administrative responsibilities, including reporting requirements in a timely fashion Qualifications Advanced degree (MD, PhD, PharmD, DNP) in a related discipline strongly preferred Less than 2 years of experience [Entry level as Associate Director]; 2+ years of experience [Entry Level as Director] of previous Field Medical or Medical Affairs pharmaceutical industry [post-doctoral pharmaceutical industry training via residency or fellowship also welcomed] Active clinical care, clinical research, or academia experience preferred Clear understanding of regional medical practice, clinical decision-making and healthcare systems affecting patient care. Demonstrated strong understanding of clinical research trial and/or related laboratory research design and execution Extensive knowledge of Endocrinology, including Cushing's Disease and field medical affairs is strongly preferred. Competencies: Customer Service focus, Teamwork & Collaboration, Written and Verbal Communication skills, Presentation skills, Time Management skills, Self-Starter. Working Conditions: Position may require periodic evening and weekend work, as necessary to fulfill obligations. Periodic overnight travel. Approximately 60% overnight travel The level of the position will be determined based on the selected candidate's qualifications and experience. #LI-REMOTE As an equal employment opportunity and affirmative action employer, Xeris Pharmaceuticals, Inc. does not discriminate on the basis of race, color, religion, sex, gender identity, sexual orientation, national origin, age, disability, veteran status, genetics or any other characteristic protected by law. It is our intention that all qualified applications are given equal opportunity and that selection decisions be based on job-related factors. The anticipated base salary range for this position is $170,000 to $225,000. Final determination of base salary offered will depend on several factors relevant to the position, including but not limited to candidate skills, experience, education, market location, and business need. This role will include eligibility for bonus and equity. The total compensation package will also include additional elements such as multiple paid time off benefits, various health insurance options, retirement benefits and more. Details about these and other offerings will be provided at the time a conditional offer of employment is made. Candidates are always welcome to inquire about our compensation and benefits package during the interview process. NOTE: This job description is not intended to be all-inclusive. Employee may perform other related duties as negotiated to meet the ongoing needs of the organization.
    $170k-225k yearly Auto-Apply 6d ago
  • Veterinary Group Medical Director

    Bluepearl 4.5company rating

    Remote forensic medical examiner job

    If you are a current associate, you will need to apply through our internal career site. Please log into Workday and click on the Jobs Hub app or search for Browse Jobs. BluePearl is searching for an experienced, motivating, and driven clinical leader to join our team as a Group Medical Director! This is a remote position overseeing multiple hospital locations within our Central Division. The Group Medical Director (GMD) has medical oversight of multiple markets within the organization with combined revenues of approximately $100MM or greater. The incumbent has the ultimate responsibility for translation of organizational objectives into market-specific objectives that instill a clinician-driven culture, promote clinician engagement and retention, and yield strong fiscal performance. A GMD frequently travels to hospitals to evaluate and mentor medical leaders and address concerns. The role partners with other members of the field leadership team to ensure a balanced representation of medical quality and financial considerations and the people & organization department to champion consistency in a high performance and engaged workforce united in being BluePearl. As a GMD, you will: Identify, oversee and develop medical leaders (Medical Directors and their ER Service Team Leads) to ensure optimal clinician productivity and engagement. Responsible for creating a clinician-driven culture in assigned markets. Serve as high-level representative and champion of BluePearl mission and vision in all interactions within the organization and external veterinary community. Partner with field leaders to effectively communicate and cascade key initiatives impacting medical staff. Foster a collaborative and trusting relationship between the support team and hospitals. Partner with field leaders to ensure appropriate productivity levels and growth plans for clinicians and hospitals, including maximizing technical teams. Monitor reports on operating costs within functional areas. Alerts hospital leaders of cost and labor over run. Partners with field leaders, finance and P&O to assess concerns and implement solutions. Own the success of on-site visit process for DVM candidates in assigned markets, ensures onboarding and mentoring of new BluePearl Clinicians through BluePearl Mentorship Program. Ensure standards for medical quality, patient safety reporting, equipment, and clinician productivity/performance are met. Partner with assigned Vet Relations team to collaborate on pDVM referral strategies that impact assigned markets. Oversee and encourage support of continuing education programs across assigned markets and ensures programs sufficiently develop and engage technicians and clinicians to deliver remarkable care to patients. Monitor reports on medical occurrences, patient safety and client experience and partners with stakeholders as needed to ensure swift resolution, improvements, and/or coaching as needed. Work collaboratively with the BluePearl Support Team to develop solutions for escalated concerns and influences medical leaders to shape adoption and ensure effectiveness of resolutions. Travel around 50% to ensure in-person leadership and mentoring in hospitals. EDUCATION/EXPERIENCE Bachelor's Degree and DVM (Doctor of Veterinary Medicine) required. Completion of 1-year rotating internship required. May be Emergency Clinician or board-certified Specialty Clinician. 7+ years of leadership experience required (previously overseeing multiple sites or revenues exceeding $25MM preferred.) Why BluePearl? Our passion is pets. We offer Trupanion pet insurance and discounts to our associates for pet treatments, procedures, and food. We encourage you to grow with us. Our technicians are leveled by their skillset and move up in level as they gain more skills and experience. We are focused on developing our associates into leaders through talent development programs and leadership workshops. As a member of Mars Veterinary Health, our associates have endless opportunities to advance in his/her career. In order to transform and lead the industry through innovative quality medicine and care, we understand the importance of continuous learning. We offer annual continuing education allowance, free continuing education sessions, our own BluePearl University for training, and our clinicians have access to over 2,000 medical journals. We value your health and well-being as an associate by providing you with the following: Health, dental, vision, and life insurance options. Annual company store allowance. Flexible work schedules. Time to reset, rewind, and reflect through our paid time off, paid parental leave, and floating holiday plans. A regional licensed social worker who can provide guidance, advice, and tips/tricks on how to maintain a healthy lifestyle while working in a fast-paced emergency and specialty care environment. We promote a family-like culture in our hospitals. We are all in this together. We believe in working together to lead the industry by enriching lives through remarkable care for pets For additional details or questions, please email *********************************. BluePearl is committed to a diverse work environment in which all individuals are treated with respect and dignity. We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, creed, sex, age, disability, genetic information, marital status, citizenship status, sexual orientation or affectional preference, or gender identity or expression, protected veteran status, or any other characteristic protected by law. If you need assistance or an accommodation during the application process because of a disability, it is available upon request. The company is pleased to provide such assistance, and no applicant will be penalized as a result of such a request. We are an Equal Opportunity Employer and a Drug Free Workplace.
    $140k-239k yearly est. Auto-Apply 60d+ ago
  • Oncology Clinical Development Medical Director (Development Physician, IOD)

    Astellas Pharma 4.9company rating

    Remote forensic medical examiner job

    Do you want to be part of an inclusive team that works to develop innovative therapies for patients? Every day, we are driven to develop and deliver innovative and effective new medicines to patients and physicians. If you want to be part of this exciting work, you belong at Astellas! Astellas Pharma Inc. is a pharmaceutical company conducting business in more than 70 countries around the world. We are committed to turning innovative science into medical solutions that bring value and hope to patients and their families. Keeping our focus on addressing unmet medical needs and conducting our business with ethics and integrity enables us to improve the health of people throughout the world. For more information on Astellas, please visit our website at **************** . This position is based in Northbrook, Illinois. Remote work from certain states may be permitted in accordance with Astellas' Responsible Flexibility Guidelines. Candidates interested in remote work are encouraged to apply. **Purpose and Scope:** + Responsible for overseeing the design and delivery of trials within a given late phase program or multiple early-phase programs in the Immuno-Oncology group. + Reports to the Medical Lead/disease area strategy head for the given program(s) and is accountable for defining the strategy and execution of assigned trials. + Clinical team leader with clear understanding of areas of responsibilities and accountabilities of the role. Team player who is comfortable in situations where the role serves as a consultant and support to other functions and particularly the asset area. Understands the criticality of information and knowledge management, partnership and collaboration required in drug development. **Essential Job Responsibilities:** + Collaborates effectively with key internal and external stakeholders as a member of the asset team and leader of the clinical study team to advance one or more clinical trials. Serves as Medical Monitor w/ responsibility for safety monitoring. + Ensures patient safety on clinical study is maintained. Generates safety related documents, such as medical monitoring reports and the safety database, to ensure that the reporting of SAEs is current and complete. + Collaborates closely with safety officer in writing and/or reviewing Safety Narratives, Investigator Letters, and other safety documentation for site-reported safety events. + Coordinates with Safety Officer on program for appropriate benefit-risk assessments, planning FIH study dose selection and escalation path for early-phase programs, safety management on trials, provides clinical input and review of clinical documents, statistical analysis plans, interim and final analyses on trials, publications, CSRs, DSURs and other critical documents. + Able to assimilate Research, Clinical Pharmacology, Biomarker, medical safety, Toxicology (early phase programs) regulatory, biostatistics, medical affairs, Health Economics, commercial perspectives into clinical development strategies and trial designs. + Responsible for managing the process of development of protocol and necessary regulatory documents. + Accountable and responsible for development and implementation, and execution of clinical trials as part of a large complex late phase (post POC, established market) program or a group of earlier stage programs, in alignment with Asset and overall clinical strategy. + In late phase program serves as the Lead for an indication specific clinical development team and is responsible and accountable for both strategy and execution of the clinical development plan for that indication or line of therapy. + In earlier phases, serves as the clinical lead for the entire clinical development strategy and execution for a given program. + Acquires public knowledge regarding therapeutic landscape, potential competitor products and serves as clinical voice regarding the potential for impact on planned clinical, medical affairs and commercial strategies. + Creates and maintains scientific/clinical networks and seeks external opinion leader as appropriate. Serve as the clinical interface during clinical advisory boards, investigator meetings, and interactions with opinion leaders. Serves as the clinical interface in regulatory authority interactions. + Accountable for clinical development milestones for their given trials. Supports Medical lead and Asset team at governance meetings and can present the clinical development plan in a succinct and clear manner at such meetings. + Works with Development Scientists and Clinical Operation Leads to ensure efficient and streamlined execution of clinical trials and acquisition and interpretation of high-quality clinical data to inform program-level decision making and overall development strategies. + Designs scientifically rigorous, cost-effective, and patient-centric clinical trials in accordance with the Clinical development Plan. Accountable for Clinical trial scope development and authoring of the protocol, IB, ICF as appropriate, in coordination with development scientists, clinical operations, medical writing and regulatory. + Responsible for keeping medical lead, asset lead and Development Head informed on progress of trials, risks, planned/required mitigations, and changes to timelines and budgets. + Supports clinical development related initiatives as needed. Leads and/or participates in scientific and medical training to other team members and external clients, investigators, and other site staff as it pertains to assigned studies. **Qualifications:** **Required** + MD or MD/PhD with oncology fellowship complete. Board certified with patient treatment experience beyond fellowship preferred. + Must have 5 years of pharmaceutical industry or academia experience specifically in clinical trial design and execution in a bio-pharmaceutical development organization or a balance of experience at an academic institution and a pharmaceutical company. + Proven record of designing clinical trials that can produce high quality data in a timely manner for decision making. + Documented experience planning and managing clinical trials, serving as medical monitor, managing trial execution in coordination with clinical operations. + Excellent verbal and written communication skills in English. + Experience working in global teams and a global matrixed, remote working environment. + Aware of cultural diversity and how to influence and manage in a multi-cultural organization. + Highest level of scientific integrity and impeccable work ethics **Preferred:** + Extensive experience in gastroesophageal or thoracic oncology or immuno-oncology in solid tumors + Prior clinical research experience in an academic setting + Experience in all phases of Clinical Development and interfaces with Drug Discovery through Marketing. + Direct experience leading global regulatory marketing authorization submissions and defense of those submissions **Salary Range:** $215,600 - $338,800 (Final compensation will be determined based on a variety of factors, including but not limited to skills, experience and organizational equity considerations) **Benefits:** + Medical, Dental and Vision Insurance + Generous Paid Time Off options, including Vacation and Sick time, plus national holidays including year-end shut down + 401(k) match and annual company contribution + Company paid life insurance + Annual Corporate Bonus and Quarterly Sales Incentive for eligible positions + Long Term Incentive Plan for eligible positions + Company fleet vehicle for eligible positions + Referral bonus program Category Oncology Development Astellas is committed to equality of opportunity in all aspects of employment. EOE including Disability/Protected Veterans
    $215.6k-338.8k yearly 5d ago
  • REMOTE - Medical Director, Health Plan

    Martin's Point Health Care 3.8company rating

    Remote forensic medical examiner job

    Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to transform our health care system while creating a healthier community. Martin's Point employees enjoy an organizational culture of trust and respect, where our values - taking care of ourselves and others, continuous learning, helping each other, and having fun - are brought to life every day. Join us and find out for yourself why Martin's Point has been certified as a "Great Place to Work" since 2015. Position Summary The Medical Director (MD) provides clinical leadership and direction to the utilization & care management functions of Martin's Point's Health Plans. The MD works collaboratively with other plan functions that interface with Medical Management such as Health Management, Compliance and Appeals, , Network Management, Member Services, benefits & claims management, and Compliance. In this role, there is the opportunity to assist in or drive short and long-range clinical programming, quality management, and external relationships. The Medical Director reports to the Vice President Health Plan Medical Director and works closely with the other Health Plan leaders. Job Description Key Outcomes: Responsible and accountable to the Health Plan Medical Director for helping to manage health plan medical costs by assuring clinically appropriate health care delivery for health plan products and services utilizing Evidence-Based Guidelines to ensure the right service at the right time and place for each member Performs medical necessity reviews of requests for health plan-covered services (benefits). Reviews disputes and appeals of said services for clinical appropriateness and in compliance with government program rules Contributes to case reviews to ensure the quality and safety of care and services delivered to Martin's Point Health Plan members. Assists in the construction of the annual Utilization Management, Care Management, and Disease Management Program Descriptions and works to ensure the programs meet accreditation and regulatory standards (e.g. NCQA, CMS, TRICARE) Participates in medical policy review and policy development. Works with Informatics, Network Management, and Medical Economics to create and maintain a system where Network providers are properly assessed in regard to cost management and develops a plan and schedule for communication and solutioning with outliers. Develops an in-depth understanding of ACOs and contributes to their management and strategic deployment. Provides support to Health Plan risk adjustment activities as needed. Is conversant with Health Plan key performance metrics, in particular utilization and cost management goals, MLR , inpatient days/1000, SNF days/1000, and clinical quality improvement (QI) objectives, including HEDIS and how to drive improvement in these areas Education/Experience: Board certified physician with post-graduate experience in direct patient care required Medical leadership in, or focused activity of, a Health Plan (preferred) Knowledge of process improvement tools Experience in Health Plan utilization management Experience in Medicare Advantage and/or TriCare preferred Required License(s) and/or Certification(s): Active and unrestricted license to practice medicine in Maine or New Hampshire; or another U.S. state with eligibility to apply for and obtain additional state licensure. Current, or ability to have some, active clinical work with patients Skills/Knowledge/Competencies (Behaviors): Deep knowledge and practical understanding of Health Care systems and Managed Care concepts Knowledge and deep commitment to performance-based Health Plan systems Good analytic skills with the ability to identify meaningful trends and targets for improvement Excellent interpersonal skills and demonstrated ability to establish rapport and working relationships with providers, service vendors and internal staff Willingness to explore innovative methods of providing medical management Supports the culture and models the MPHC values This position is not eligible for immigration sponsorship. We are an equal opportunity/affirmative action employer. Martin's Point complies with federal and state disability laws and makes reasonable accommodations for applicants and employees with disabilities. If a reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact ***************************** Do you have a question about careers at Martin's Point Health Care? Contact us at: *****************************
    $250k-353k yearly est. Auto-Apply 5d ago
  • Medical Director

    Arc Group 4.3company rating

    Remote forensic medical examiner job

    Job DescriptionMEDICAL DIRECTOR - REMOTE ARC Group has an immediate opportunity for a Medical Director! This position is 100% remote working eastern time zone business hours. This is a direct hire FTE position and a fantastic opportunity to join a well-respected organization and have a positive impact on the lives of millions of people. At ARC Group, we are committed to fostering a diverse and inclusive workplace where everyone feels valued and respected. We believe that diverse perspectives lead to better innovation and problem-solving. As an organization, we embrace diversity in all its forms and encourage individuals from underrepresented groups to apply. 100% REMOTE! Candidates must currently have PERMANENT US work authorization. Sorry, but we are not considering any candidates from outside companies for this position (no C2C, 3rd party / brokering). SUMMARY STATEMENT The Medicare Contractor Medical Director (CMD) provides medical leadership and decision making for an organization that serves as a Medicare Administrative Contractor (MAC). This role serves as a liaison between the Centers for Medicare and Medicaid Services (CMS) and stakeholders. CMDs play a vital role in developing Local Coverage Determinations (LCDs) and ensuring compliance with Medicare policies, reviewing medical claims, and promoting evidence-based healthcare. ESSENTIAL DUTIES & RESPONSIBILITIES Clinical Expertise and Consultation 30% Provide leadership in clinical program outreach to the practitioner/provider/supplier/beneficiary community. Provide direction and assistance to clinical staff in conducting provider education, as well as assist in the development of clinical guidelines as needed. Keep clinical knowledge up to date and abreast of medical practice and technology changes. Serve as a subject matter expert in medical and clinical areas relevant to the Medicare program. Provide clinical consultation to internal teams (e.g., medical review staff, appeals teams) and external stakeholders. Provide the clinical expertise, scientific literature analysis, claims data analytics to effectively focus medical polical policy and reviews on identified problem areas. Collaboration and Leadership 30% Collaborate with CMS and other Medicare Contractors (e.g., A/B or DME MACs and others) to develop and update medical policies and articles based on clinical evidence and regulatory requirements. Work with multidisciplinary teams within the MAC to improve processes and ensure compliance with CMS directives. Liaise with CMS staff, medical societies, and other stakeholders to align goals and address emerging issues. Represent the MAC at CMS meetings and industry conferences. Strengthen the quality improvement procedures with emphasis on decision consistency and clinical education of clinical staff through various mechanisms including but not limited to overseeing Inter-Reviewer Reliability (IRR) reviews. Program Integrity 20% Support program integrity initiatives, including identifying trends in inappropriate billing practices or noncompliance. Ensure the proper application of Medicare regulations, national and local coverage determinations (NCDs and LCDs), and clinical guidelines. Participate in all phases of LCD development by leading the Local Coverage Determination (LCD) process to include development, revision, retirement, education, and decision making. Collaborate with investigative teams and law enforcement when required. Medical Review (MR) and Appeals 10% Oversee medical review activities to ensure appropriate and consistent decisions on claim determinations including pre- and post-payment determinations. Provide leadership in developing and implementing MR Quality Assurance Programs. Provide leadership in effectively focusing MR and developing internal MR guidelines. Review complex or high-level appeals and provide guidance on the application of Medicare policies. Provide support to the claim appeal process including assistance in the development of position papers and participation in the administrative process when needed such as Administrative Law Judge (ALJ) hearings. Provider Education and Communication 10% Provide leadership in the provider community (including interacting with hospital/specialty associations). Educate providers, individually or as a group, regarding identified problems or medical policy. Maintain Professional and Organization Relationships Performs other duties as the supervisor may, from time to time, deem necessary. Travel within and outside the assignedjurisdictions, as needed. Expected to be no more than 3-4 weeks/year but could vary based on business needs. REQUIRED QUALIFICATIONS MD or DO degree from accredited Medical School Minimum of three years clinical practice experience as an attending physician Extensive knowledge of the Medicare program, particularly the coverage and payment rules Work experience in the health insurance industry, a utilization review firm, or another health care claims processing organization in a role that involved developing coverage or medical necessity policies and guidelines. Knowledge, skill, and experience to evaluate clinical evidence, and to develop evidence-based medical necessity standards within the Medicare fee-for-service benefit structure Ability to develop strategies and processes to ensure evidence-based decision-making for policy in the Medicare population Basic understanding of medical coding conventions Ability to effectively communicate, collaborate with, and provide education on health care policy issues to both internal team members and external entities Ability to work collaboratively with internal staff to evaluate aberrancies, determine appropriate billing, coding, pricing, and utilization of services Proficiency with effective public speaking and ability educate providers Ability to work collaboratively with clinical and non-clinical team members Ability and desire to educate team members and external entities (i.e., CMS, providers, other federal agencies, law enforcement, etc.) Computer literacy, including proficiency using word processing, spreadsheets, presentation, and virtual meeting applications Ability to complete independent or computer-based training and education Certifications, Licenses, Registration: Current, active, valid, unrestricted license to practice medicine in at least one state or territory within the United States, never suspended or revoked in any state or territory of the United States Eligible for licensure within jurisdiction of enterpriseoperations Board Certified Doctor of Medicine or a Doctor of Osteopathy in a specialty recognized by the American Board of Medical Specialties for at least three years PREFERRED QUALIFICATIONS Experienced Physical Medicine and Rehabilitation (PM&R), Oncology, Radiology, Ophthalmology or Infectious Diseases professionals with five years of clinical practice MBA, MHA, MS in Management, or formal accredited coursework in medical systems management Demonstrated successful working experience in organized medicine group(s) (e.g., AMA, specialty society, state health department) as a committee chairperson or other leadership Medical Director experience in Medicare-related or commercial healthcare organization Coding and billing experience utilizing HCPCs, CPT, and ICD-10 codes Experience using GRADE methodology for literature analysis and performing systematic reviews Experience working with physician groups, beneficiary organizations, and/or congressional offices Would you like to know more about our new opportunity? For immediate consideration, please send your resume directly to John Burke at ******************** or apply online while viewing all of our open positions at ******************* ARC Group is a Forbes-ranked a top 20 recruiting and executive search firm working with clients nationwide to recruit the highest quality technical resources. We have achieved this by understanding both our candidate's and client's needs and goals and serving both with integrity and a shared desire to succeed. At ARC Group, we are committed to providing equal employment opportunities and fostering an inclusive work environment. We encourage applications from all qualified individuals regardless of race, ethnicity, religion, gender identity, sexual orientation, age, disability, or any other protected status. If you require accommodations during the recruitment process, please let us know. Position is offered with no fee to candidate.
    $144k-225k yearly est. Easy Apply 8d ago
  • Medical Director

    Lancesoft 4.5company rating

    Remote forensic medical examiner job

    Required licensure: TX, KY, FL, WA licenses are preferred The Behavioral Health Physician will serve as an independent contractor providing physician-level utilization management (UM) services for behavioral health services. This role is non-clinical and limited exclusively to medical necessity determinations, peer-to-peer reviews, and appeals in accordance with applicable regulations, accreditation standards, and plan policies. Scope of Services The Contractor will perform UM activities including, but not limited to: Initial Medical Necessity Reviews for behavioral health services requiring physician-level determination Concurrent Reviews for continued authorization of services Peer-to-Peer (P2P) Reviews with treating providers Appeals Reviews, including first- and second-level determinations, as applicable Issuance of adverse determinations when clinically indicated, ensuring compliance with federal and state regulations, parity requirements, and plan policies Documentation of determinations in UM systems with clear clinical rationale and supporting criteria Participation in quality improvement processes related to UM decisions, as requested Exclusions / Non-Scope This role does not include: Direct patient care or treatment Prescribing services Care coordination or case management Administrative leadership or supervisory responsibilities Clinical Expertise & Requirements MD or DO with board certification in Psychiatry (required) Active, unrestricted medical license in applicable state(s) of review Experience in behavioral health utilization management, preferably in managed care or health plan settings Demonstrated knowledge of: Medical necessity criteria (e.G., MCG, InterQual, or equivalent) Federal and state behavioral health regulations MHPAEA requirements NCQA and CMS standards Strong peer-to-peer communication skills Work Expectations Remote work environment Flexible scheduling based on case volume and turnaround time requirements Ability to meet required regulatory and contractual decision timelines Maintain confidentiality and comply with HIPAA and data security standards Reporting & Oversight Operates independently while adhering to health plan UM policies, delegated authority parameters, and medical policy Subject to audit, quality oversight, and performance monitoring consistent with UM regulatory requirements
    $180k-291k yearly est. 28d ago
  • Associate Director, Medical Omnichannel Data Scientist

    Otsuka America Pharmaceutical Inc. 4.9company rating

    Forensic medical examiner job in Columbus, OH

    **About Otsuka** We defy limitation, so that others can too. In going above and beyond-under any circumstances-for patients, families, providers, and for each other. It's this deep-rooted dedication that drives us to uncover answers to complex, underserved medical needs, so that patients can push past the limitations of their disease and achieve more than they thought was possible each day. **About the Role** The Omnichannel Center of Excellence is dedicated to driving innovation, building, and delivering capabilities that enhance Otsuka's opportunity to make an impact in the lives of those we serve. We achieve this through our relentless focus on customer centricity, patient empathy, expertise in enabling pathways for disease education and awareness of management options, and our unwavering commitment to supporting access to treatment. We are looking for an **Omnichannel Data Scientist** , **Medical Omnichannel** with strong expertise in artificial intelligence, encompassing machine learning, data mining, and information retrieval. This position specifically entails the conceptualization, prototyping and development of next generation advanced analytics model-based decision engines and services. The ideal candidate will engage closely with key stakeholders to understand strategic objectives and leverage advanced data analytics and machine learning techniques to enhance communication strategies, ensuring seamless and personalized interactions with healthcare professionals (HCPs) and key opinion leaders (KOLs). **Job Expectations/Responsibilities:** **Data Integration & Management** + Explore and analyze common pharmaceuticals data (e.g., claims) as well as novel data sets based on lab and EHR systems. Work with Omnichannel Data Engineer to Integrate data from multiple sources (e.g., CRM systems, social media, email platforms) to create a unified view of stakeholder interactions. + Apply natural language processing (NLP) to extract insights from unstructured medical texts, such as clinical notes or call center transcripts. + Identifying relevant data drivers (features) that can inform decision making closely tied with strategy and creating visualizations to help communicate findings. **Advanced Analytics & Modeling** + Implement advanced analytics models, including predictive analytics and clustering algorithms, to generate actionable insights and track trends across various channels. + Work with Omnichannel ML/Ops engineer to build, test, and deploy production-grade predictive models and algorithms as part of the Omnichannel COE decision engine to meet business needs, including optimization of sales activities and predicting drivers of customer behavior. + Create repeatable, interpretable, dynamic, and scalable models that are seamlessly incorporated into analytic data products and match the needs of Otsuka's growing portfolio. + Collaborate on MLOPS life cycle experience with MLOPS workflows traceability and versioning of datasets. Build and maintain familiarity with Otsuka Machine Learning tech stack including AWS, Kubernetes, Snowflake, and Dataiku **Omnichannel Optimization** + Design and deploy recommendation systems to tailor communications based on stakeholder preferences and behaviors. Utilize machine learning algorithms (e.g., collaborative filtering, content-based filtering) to enhance personalization efforts. + Analyze the performance of omnichannel campaigns (email, SMS, in-app, HCP portals, etc.) to identify high-impact touchpoints and optimize engagement strategies. Use A/B testing and uplift modeling to evaluate the effectiveness of different communication strategies and content types. **Stakeholder Collaboration** + Effectively communicating analytical approach to address strategic objectives to business partners. + Work closely with medical affairs, marketing, and IT teams to ensure alignment and integration of omnichannel strategies. Provide technical guidance and support to cross-functional teams on data-related projects. + Stay updated with emerging industrial trends (Conferences and community engagement) and develop strategic industry partnerships on Omnichannel analytics to strengthen Otsuka's analytical methods and outcomes. + Model Otsuka's core competencies (Accountability for Results, Strategic Thinking & Problem Solving, Patient & Customer Centricity, Impact Communications, Respectful Collaboration & Empowered Development) that define how we work together at Otsuka. Key matrixed partners included: Brand Marketing, Creative / CRM / Digital agencies, Media, Market Research, Analytics, Otsuka Information Technology (OIT), Sales Operations, and Medical/Regulatory/Legal integrated business partners. **Minimum Qualification:** + Bachelor's degree in data sciences, computer science and 4-6 years of relevant experience **Preferred Knowledge, Skills, and Abilities:** + Demonstrated experience with scripting and implementing data analytics algorithms and models. Hands on experience using a modeling and simulation software (e.g. Python, Matlab, R, NONMEM, SAS, S-Plus, etc.) is a plus. + Knowledge/Experience in the usage of machine learning/AI tools in life science area(s) and handling life science datasets is preferred. + Excellent interpersonal, technical, and communication skills to lead cross-functional teams. + Profound grasp of Machine Learning lifecycle - feature engineering, training, validation, scaling, deployment, scoring, monitoring, and feedback loop. + Have implemented machine learning projects from initiation through completion with particular focus on automated deployment and ensuring optimized performance. + Agile skills and experience + Experience in Healthcare (esp. US) industry is a plus. **Competencies** **Accountability for Results -** Stay focused on key strategic objectives, be accountable for high standards of performance, and take an active role in leading change. **Strategic Thinking & Problem Solving -** Make decisions considering the long-term impact to customers, patients, employees, and the business. **Patient & Customer Centricity -** Maintain an ongoing focus on the needs of our customers and/or key stakeholders. **Impactful Communication -** Communicate with logic, clarity, and respect. Influence at all levels to achieve the best results for Otsuka. **Respectful Collaboration -** Seek and value others' perspectives and strive for diverse partnerships to enhance work toward common goals. **Empowered Development -** Play an active role in professional development as a business imperative. Minimum $164,530.00 - Maximum $245,985.00, plus incentive opportunity: The range shown represents a typical pay range or starting pay for individuals who are hired in the role to perform in the United States. Other elements may be used to determine actual pay such as the candidate's job experience, specific skills, and comparison to internal incumbents currently in role. Typically, actual pay will be positioned within the established range, rather than at its minimum or maximum. This information is provided to applicants in accordance with states and local laws. **Application Deadline** : This will be posted for a minimum of 5 business days. **Company benefits:** Comprehensive medical, dental, vision, prescription drug coverage, company provided basic life, accidental death & dismemberment, short-term and long-term disability insurance, tuition reimbursement, student loan assistance, a generous 401(k) match, flexible time off, paid holidays, and paid leave programs as well as other company provided benefits. Come discover more about Otsuka and our benefit offerings; ********************************************* . **Disclaimer:** This job description is intended to describe the general nature and level of the work being performed by the people assigned to this position. It is not intended to include every job duty and responsibility specific to the position. Otsuka reserves the right to amend and change responsibilities to meet business and organizational needs as necessary. Otsuka is an equal opportunity employer. All qualified applicants are encouraged to apply and will be given consideration for employment without regard to race, color, sex, gender identity or gender expression, sexual orientation, age, disability, religion, national origin, veteran status, marital status, or any other legally protected characteristic. If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation, if you are unable or limited in your ability to apply to this job opening as a result of your disability. You can request reasonable accommodations by contacting Accommodation Request (EEAccommodations@otsuka-us.com) . **Statement Regarding Job Recruiting Fraud Scams** At Otsuka we take security and protection of your personal information very seriously. Please be aware individuals may approach you and falsely present themselves as our employees or representatives. They may use this false pretense to try to gain access to your personal information or acquire money from you by offering fictitious employment opportunities purportedly on our behalf. Please understand, Otsuka will **never** ask for financial information of any kind or for payment of money during the job application process. We do not require any financial, credit card or bank account information and/or any payment of any kind to be considered for employment. We will also not offer you money to buy equipment, software, or for any other purpose during the job application process. If you are being asked to pay or offered money for equipment fees or some other application processing fee, even if claimed you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to exercise caution when you receive such an offer of employment. Otsuka will also never ask you to download a third-party application in order to communicate about a legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo, Gmail, Hotmail, etc, and not from an official Otsuka email address. Please take extra caution while examining such an email address, as the scammers may misspell an official Otsuka email address and use a slightly modified version duplicating letters. To ensure that you are communicating about a legitimate job opportunity at Otsuka, please only deal directly with Otsuka through its official Otsuka Career website ******************************************************* . Otsuka will not be held liable or responsible for any claims, losses, damages or expenses resulting from job recruiting scams. If you suspect a position is fraudulent, please contact Otsuka's call center at: ************. If you believe you are the victim of fraud resulting from a job recruiting scam, please contact the FBI through the Internet Crime Complaint Center at: ******************* , or your local authorities. Otsuka America Pharmaceutical Inc., Otsuka Pharmaceutical Development & Commercialization, Inc., and Otsuka Precision Health, Inc. ("Otsuka") does not accept unsolicited assistance from search firms for employment opportunities. All CVs/resumes submitted by search firms to any Otsuka employee directly or through Otsuka's application portal without a valid written search agreement in place for the position will be considered Otsuka's sole property. No fee will be paid if a candidate is hired by Otsuka as a result of an agency referral where no pre-existing agreement is in place. Where agency agreements are in place, introductions are position specific. Please, no phone calls or emails.
    $164.5k yearly 60d+ ago
  • Health Plan Medical Director

    Brigham and Women's Hospital 4.6company rating

    Remote forensic medical examiner job

    Site: Mass General Brigham Health Plan Holding Company, Inc. Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. Job Summary Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are on the forefront of transformation with one of the world's leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage. Our work centers on creating an exceptional member experience - a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a consciously inclusive environment where diversity is celebrated. We are pleased to offer competitive salaries, and a benefits package with flexible work options, career growth opportunities, and much more. Under the direction of the Senior Medical Director, the Medical Director leads as a senior physician at the health plan. This position works closely with the Senior Medical Director in providing medical management leadership for clinical services operations and programs. This role focuses on and has expertise in utilization management, health plan quality and accreditation, care management, and other health plan functions. Qualifications Licensure and Credentials: Must maintain an active full physician license in Massachusetts Experience: * 3-5 years of Health Plan experience * at least 5 years of clinical practice experience Job Duties: Handles utilization management initial determinations, appeals and grievances within the scope of their expertise as defined by Medicare, MassHealth, NCQA and the Division of Insurance and within the compliance requirements of key regulatory and accreditation entities * Reviews clinical services and quality incidents when sufficiently serious to merit physician involvement * Coverage of medical necessity determinations to support special investigations/fraud waste and abuse cases * Collaborates on health plan medical policy development * Assesses new, emerging, and existing technologies to determine appropriateness of health plan coverage * Partners with clinical leaders to ensure medical service expenditures remain within budget * Collaborates with business development, quality, finance and medical management teams to promote improvements in the quality and cost efficiency of care throughout the MGB Health Plan provider network * Delivers consultation to network management staff and deployment of education programs for network clinicians * Develops and delivers presentations for clinical staff on current topics relevant to MGB Health Plan members and network * May represent MGB Health Plan at a variety of external forums and committees * Interact, communicate and collaborate with network and community physicians, hospital leaders and other vendors regarding care and services for enrollees * Monitors performance metrics and audits to identify areas for continuous improvement and ensure compliance * Anticipates and meets or exceeds internal and/or external customer expectations and requirements; establishes and maintains positive relationships with customers and gains their trust and respect * Build strong relationships and infrastructure that designate MGB Health Plan as a people-first organization * Ensure diversity, equity and inclusion are integrated as a guiding principle * Other duties as assigned with or without accommodation Additional Job Details (if applicable) Primarily remote position, exempt * In person meetings as requested for business needs * Participates in after hours and weekend call rotation as assigned Remote Type Remote Work Location 399 Revolution Drive Scheduled Weekly Hours 40 Employee Type Regular Work Shift Day (United States of America) EEO Statement: Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at **************. Mass General Brigham Competency Framework At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.
    $179k-266k yearly est. Auto-Apply 34d ago

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