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Medical director jobs in Baton Rouge, LA

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  • Director of Laboratory Services

    Lighthouse Lab Services

    Medical director job in Baton Rouge, LA

    Lighthouse Lab Services has partnered with a large healthcare organization in the epicenter of Louisiana seeking a Director of Laboratory Services. This individual would be a part of their growing operation in Baton Rouge, LA. ABOUT BATON ROUGE, LA: Baton Rouge, Louisiana, blends Southern charm, cultural richness, and modern opportunity. With a cost of living well below national averages, residents enjoy affordable comfort and a vibrant lifestyle. The city's Cajun and Creole cuisine, lively music, and annual festivals celebrate its unique Louisiana heritage. Home to LSU and a growing research and technology hub, Baton Rouge offers strong professional and educational opportunities. From scenic riverfront trails to the energy of LSU game days, Baton Rouge is affordable, flavorful, and full of heart. It is a place where life moves to its own joyful rhythm. ABOUT THE CLIENT: For generations, the client has been a cornerstone of the community, adapting through historic advances in medicine, technology, and patient needs. The hospital has expanded access to care and simplified the healthcare experience, now offering more than 600 licensed beds across three campuses. From delivering newborns to providing compassionate hospice care, they deliver the full spectrum of healthcare services. Its acclaimed, award-winning cancer and heart programs, and network of clinics across the region reflect a steadfast commitment to comprehensive, patient-centered care for every stage of life. ABOUT THE ROLE: The Director of Laboratory Services is responsible for the overall operation and administration of the Laboratory including the employment of personnel who are competent to perform test procedures, record and report test results promptly and accurately and for assuring compliance with the applicable regulations. With oversight of strategic planning, direction and overall accountability all Laboratory Services, the Director of Laboratory Services independently makes decisions that could seriously affect the overall division and/or the hospitals financial and performance objectives and strategic results. They will actively participate in committees responsible for establishing related policies and procedures. They will develops oversee department budget, direct reports including managers, supervisors and staff to include responsibility for performance reviews, hiring, disciplinary actions and terminations. KEY RESPONSIBILITIES: Demonstrate courtesy and caring for each other, patients and their family, physicians, and the community. Take initiative in living our values and vital signs. Take initiative in identifying customer needs before the customer asks. Participate in teamwork willingly and with enthusiasm. Demonstrate respect for the dignity and privacy needs of customers through personal action and attention to the environment of care. Keep customers informed, answers customer questions and anticipate information needs of customers. Participate in Interdepartmental Rounding for the areas served. Practice diligence in fulfilling the regulatory and legal requirements of the position and department. Maintain accurate and reliable patient/organizational records. Maintain professional relationships with appropriate officials; communicate honesty and completely; behave in a fair and nondiscriminatory manner in all professional contacts. Set goals and action plans to achieve objectives. Complete assignments following accepted procedures and practices, even when workloads and demands are high. Adhere to high moral principles of honesty, loyalty, sincerity, and fairness (integrity). Utilize data to plan new products and services. Strive to continuously improve all aspects of the business operation through quality improvement initiatives. Assure the accuracy of data, work, or information and contributes ideas and suggestions to improve approaches, methodologies, and productivity. Utilize data to implement clinical and operational redesign efforts. Willingly participate in organization and/or department quality initiatives. Demonstrate effective time management to promote productivity and cost efficiency. Use material goods wisely, is conscious of the environment and is accountable for prudent use of our talents and financial resources. Develop appropriate budget(s) for areas of responsibility. Effectively manage budget(s) and continually monitor key cost areas. Invite input from others and share ownership and recognition. Inspire people by example and influence them to do and be their best. Inspirate and encourage teamwork. Consistently execute applicable company policies, rules and regulations. Establish clear work objectives that prioritize and focus on employee efforts. Staff work area with appropriate numbers of qualified employees. Allocate and delegate work effectively to make efficient use of resources and employee capabilities. Provide opportunities for skill development for employees. Delegate authority to supervisory and department(s) or areas of responsibility staff members. Provide direction and policy interpretation to managers. Encourage staff participation and communication in decision-making. Exhibit responsiveness to others in the organization at all levels. Assure that applicable accreditation standards and governmental regulations for areas of responsibility are continually met. Analyze services to determine means of improving efficiency, quality and cost effectiveness. Effectively plan the scope, emphasis and objectives of laboratory services. Effectively organize the Laboratory's operating systems. Effectively measure the performance and productivity of the department by means of quantitative profiling of factors such as procedures, and staff utilization. Establish and maintain communication with internal and external customers in order to ensure a timely response to new clinical service trends and program planning. Investigate and studies trends and developments in Laboratory practices and techniques. Actively participate in committees responsible for establishing related policies and procedures. Develop goals and objectives in consultation with Administration. Participate in space utilization/consolidation studies and analysis. Lead and direct the development, communication and implementation of effective growth strategies and processes. Develop recommended plans to maximize operational efficiencies. Demonstrate good planning in anticipating the replacement needs of Laboratory equipment. Knowledge of budget preparation and monitoring, and accreditation requirements. MINIMUM REQUIRED QUALIFICATIONS Bachelor's degree in medical technology, clinical laboratory, chemical, physical or biological science, or related field. Higher degree would be a plus. 5 years leadership level experience in Laboratory services preferred. MLS(ASCP) Certification preferred. Current Clinical Laboratory Scientist, Generalist, or Specialist license issued by the Louisiana State Board of Medical Examiners required. SHIFT, SALARY, BENEFITS: First shift M-F Salary starting in the $100Ks and depending on experience, education, etc Full, comprehensive benefits package. Generous PTO. Possible EOY performance based bonuses About Us: At Lighthouse Lab Services, we offer solutions to help start, grow, and run clinical laboratories. Our recruiting team has more than 22 years of proven success placing job seekers in positions ranging from entry-level Medical Technologists to seasoned Laboratory Directors. We recruit nationwide for permanent and travel positions with clients ranging from small hospitals to large reference laboratories. It is the policy of Lighthouse Lab Services to provide equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. In addition, Lighthouse Lab Services will provide reasonable accommodations for qualified individuals with disabilities. Lighthouse Lab Services|************|lighthouselabservices.com #LLS3
    $100 hourly 4d ago
  • CNI (RN) Medical Oncology Cancer Center Per Diem

    Christus Health 4.6company rating

    Medical director job in Denham Springs, LA

    Skills, Experience, Qualifications, If you have the right match for this opportunity, then make sure to apply today. The Registered Nurse is a clinical practitioner who coordinates and implements patient care specific to the age of the patient population served on the assigned units. He/she ensures that quality care is provided in an efficient and safe manner, consistent with the unit's standards of care. He/she demonstrates performance consistent with the mission, philosophy and goals of the unit and organization. Demonstrates quality and effectiveness in work habits and clinical practice. Treats staff, physicians, patients and families with consideration and respect. Requirements EDUCATION: Graduate of an accredited program for Registered Nursing. CERTIFICATION/LICENSES: Current New Mexico RN license or current Compact state license. BLS Certification required or within 2 weeks of hire date. All other required certifications must be obtained within 6 months of hire date. If nurse has the required certifications at time of hire, they must maintain the certifications and will not have a grace period to renew. SKILLS: Current knowledge and skills appropriate to age/type of patient population served. Knowledgeable and sensitive to patients' rights in the delivery of care. Communicates in a clear concise manner appropriate to the developmental age of patient. EXPERIENCE: NATURE OF SUPERVISION: -Responsible to: Patient Care Director or Manager ENVIRONMENT: - Bloodborne pathogen C (OR, PACU, L & D); - Bloodborne pathogen B (other Patient Care areas). Exposure to infectious diseases and x-rays. Works in a clean, well lighted, ventilated smoke-free environment. Subject to stressful professional relationships. Working hours are varied, with flexibility due to unexpected changes in schedule and emergencies. PHYSICAL REQUIREMENTS: Must be able to handle emergency/crisis situations, prolonged, extensive or considerable standing and walking. Requires heavy physical effort to position, push and/or transfer patients or equipment and supplies. Requires considerable reaching, stooping, bending, kneeling and crouching. Ability to judge distance and space relationships, see peripherally, distinguish and identify different colors. Hearing and visual acuity within normal or correctable limits. xevrcyc Manual dexterity and fine motor coordination required.
    $33k-72k yearly est. 2d ago
  • Medical Director - Nat'l OP Medicare

    Humana 4.8company rating

    Medical director job in Baton Rouge, LA

    **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. The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All work occurs with a context of regulatory compliance, and work is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand how to operationalize this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all submitted clinical records, prioritization of daily work, communication of decisions to internal associates, and possible participation in care management. The clinical scenarios predominantly arise from inpatient or post-acute care environments. Has discussions with external physicians by phone to gather additional clinical information or discuss determinations regularly, and in some instances, these may require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within their scope. The Medical Director may speak with contracted external physicians, physician groups, facilities, or community groups to support regional market priorities, which may include an understanding of Humana processes, as well as a focus on collaborative business relationships, value-based care, population health, or disease or care management. **Use your skills to make an impact** **Responsibilities** The Medical Director provides medical interpretation and determinations whether services provided by other healthcare professionals are in agreement with national guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) contracts. The ideal candidate supports and collaborates with other team members, other departments, Humana colleagues and the Regional VP Health Services. After completion of mentored training, daily work is performed with minimal direction. Enjoys working in a structured environment with expectations for consistency in thinking and authorship. Exercises independence in meeting departmental expectations and meets compliance timelines. **Required Qualifications** + MD or DO degree + 5+ years of direct clinical patient care experience post residency or fellowship, which preferably includes some experience in an inpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age). + Current and ongoing Board Certification an approved ABMS Medical Specialty + A current and unrestricted license in at least one jurisdiction and willing to obtain additional license, if required. + No current sanction from Federal or State Governmental organizations, and able to pass credentialing requirements. + Excellent verbal and written communication skills. + Evidence of analytic and interpretation skills, with prior experience participating in teams focusing on quality management, utilization management, case management, discharge planning and/or home health or post-acute services such as inpatient rehabilitation. **Preferred Qualifications** + **The following medical specialties: pulmonology, sleep medicine, cardiology, general surgery, radiology, interventional radiology, and genetics.** + Knowledge of the managed care industry including Medicare Advantage and Managed Medicaid. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. + Experience with national guidelines such as MCG or InterQual + Advanced degree such as an MBA, MHA, MPH + Exposure to Public Health, Population Health, analytics, and use of business metrics. + Experience working with Case managers or Care managers on complex case management, including familiarity with social determinants of health. + The curiosity to learn, the flexibility to adapt and the courage to innovate **Additional Information** Typically reports to a Regional Vice President of Health Services, Lead, or Corporate Medical Director, depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an assigned market, member population, or condition type. May also engage in grievance and appeals reviews. May participate on project teams or organizational committees. \#physiciancareers Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $223,800 - $313,100 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 02-28-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $223.8k-313.1k yearly 1d ago
  • PCO Medical Director - UM - Part Time (Hourly)

    Centerwell

    Medical director job in Baton Rouge, LA

    **Become a part of our caring community and help us put health first** The Medical Director, Primary Care relies on medical background and reviews health claims. The Medical Director, Primary Care work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. 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. The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All work occurs with a context of regulatory compliance, and work is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand how to operationalize this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all submitted clinical records, prioritization of daily work, communication of decisions to internal associates, participation in care management and possible participation in care facilitation with hospitals. The clinical scenarios predominantly arise from inpatient or post-acute care environments. There are discussions with external physicians by phone to gather additional clinical information or discuss determinations regularly, and in some instances, these may require conflict resolution skills. An aspect of the role includes an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within their scope. The Medical Director may speak with contracted external physicians, physician groups, facilities, or community groups to support regional market care facilitation and priorities, which may include an understanding of Humana processes, as well as a focus on collaborative business relationships, value-based care, population health, or disease or care management. **Use your skills to make an impact** **Responsibilities** The Medical Director provides medical interpretation and determinations whether services provided by other healthcare professionals are in agreement with national guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) contracts. The ideal candidate supports and collaborates with other team members, other departments, Humana colleagues and the Regional VP Health Services. After completion of mentored training, daily work is performed with minimal direction. Enjoys working in a structured environment with expectations for consistency in thinking and authorship. Exercises independence in meeting departmental expectations and meets compliance timelines. **Required Qualifications** + MD or DO degree. + 5+ years of direct clinical patient care experience post residency or fellowship, which preferably includes some experience in an inpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age). + Current and ongoing Board Certification in an approved ABMS Medical Specialty as well as ABQAURP, or other boarddemonstratingadvanced training in transitions of care, quality assurance,utilizationmanagementand care coordination. + A current and unrestricted license in at least onejurisdictionand willing to obtainadditionallicense, ifrequired. + No currentsanctionfrom Federal or State Governmental organizations, and able to pass credentialing requirements. + Excellent organizational,verbaland written communication skills. + Evidence of analytic and interpretation skills, with prior experienceparticipatingin teams focusing on transitions of care, quality management,utilizationmanagement, case management, discharge planning and/or home health or post-acute services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other medical management organizations, hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management. + Utilizationmanagement experience in a medical management review organization, such as Medicare Advantage,managed Medicaid, or Commercial health insurance. + Experience with national guidelines such as MCG or InterQual. + Internal Medicine, Family Practice, Geriatrics, Hospitalist, Emergency Medicine clinical specialists + Advanceddegreesuch as an MBA, MHA, MPH + Exposure to value-based care, Public Health, Population Health, analytics, and use of business metrics. + Experience working with Casemanagersor Caremanagerson complex case management, including familiarity with social determinants of health. + The curiosity to learn, the flexibility toadaptand the courage to innovate. **Additional Information** Will report to the Director of Physician Strategy at Utilization Management. The Medical Director conducts Utilization review of the care received by members in an assigned region, market, member population, or condition type. May also engage in grievance and appeals reviews. May participate on project teams or organizational committees. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 1 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $223,800 - $313,100 per year **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers benefits for limited term, variable schedule and per diem associates which are designed to support whole-person well-being. Among these benefits, Humana provides paid time off, 401(k) retirement savings plan, employee assistance program, business travel and accident. Application Deadline: 12-31-2025 **About us** About Conviva Senior Primary Care: Conviva Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. As part of CenterWell Senior Primary Care, Conviva's innovative, value-based approach means each patient gets the best care, when needed most, and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral and financial needs that can impact our patients' well-being. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Centerwell, a wholly owned subsidiary of Humana, complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our full accessibility rights information and language options *************************************************************
    $223.8k-313.1k yearly 28d ago
  • Medical Director

    Highmark Health 4.5company rating

    Medical director job in Baton Rouge, LA

    This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and most current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and appropriateness of the requested treatment of service. Depending on the nature of the case, telephonic peer to peer discussions may be required. The incumbent ensures compliance to NCQA, URAC, CMS, DOH, and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member of the multidisciplinary team for case and disease management. They will advise the multidisciplinary team on cases, particularly high-risk cases, through the team structure. Additionally, the incumbent may be assigned special projects to help support and improve the care of our members **ESSENTIAL RESPONSIBILITIES** + Conduct electronic review of escalated cases against medical policy criteria, which may include telephonic peer to peer discussions, to determine medical necessity and appropriateness. Complete initial determination of cases, review of appeals and grievances, and other reviews as assigned. Compose clear and concise rationales for member and provider determination notifications all while adhering to required compliance standards (NCQA, URAC, CMS, DOH, and DOL regulations, etc.). Ensure that all aspects of the medical management process are consistent with community standards of care. + Participate as a member of the CMDM multidisciplinary team. Attend huddles and grand rounds. Advise multidisciplinary team on cases that require physician expertise. + Participate in protocol and guidelines development to ensure consistency in the review process. + Actively manage projects and/or participate on project teams that require a physician subject matter expert. + Other duties as assigned. **EDUCATION** **Required** + Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO) **Substitutions** + None **Preferred** + Master's Degree in Business Administration/Management or Public Health **EXPERIENCE** **Required** + 5 years in Clinical, Direct Patient care (hospital, outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed care industry **LICENSES AND CERTIFICATION** **Required** + Medical Doctor or Doctor of Osteopathic Medicine (DO) + Awarded Board Certification at least once in specialty recognized by the American Board of Medical Specialties or the American Osteopathic Association Specialty Certifying Boards + Active medical state licensure required. Additional specific state licensure(s) may be required based on business need. **Preferred** + None **SKILLS** + Critical Thinking + Case Management + Customer Service + Oral & Written Communication Skills + Collaboration + Listening + Telephone Skills + General Computer Skills + Clinical Software + Managed Care **Language (Other than English)** None **Travel Required** 0% - 25% **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** Position Type Office-Based Teaches / trains others regularly Occasionally Travel regularly from the office to various work sites or from site-to-site Rarely Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required No Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Rarely Lifting: 25 to 50 pounds Rarely **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._ **_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._ _As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._ _Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._ **Pay Range Minimum:** $170,000.00 **Pay Range Maximum:** $352,500.00 _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._ Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J266916
    $170k-352.5k yearly 60d+ ago
  • Medical Director - Pediatric Anesthesiologist | 26 Weeks Off in Southern Louisiana

    Goldmatch

    Medical director job in Baton Rouge, LA

    Job Description 26 wk PEDIATRIC Anesthesia Director $750K - Foodie-Friendly town 1 hr to Baton Rouge Take on a leadership role with 26 weeks off annually in an appealing Southern Louisiana town, 1 hour from Baton Rouge. Here you will find a magnetic downtown, walkable neighborhoods, and live music around every corner. This Pediatric Anesthesiologist Medical Director position offers an exceptional lifestyle, flexible scheduling, NO CALL, and a culinary/cultural scene that was highlighted in Forbes. Highlights: $750,000 compensation package 1 or 2 week on/ off schedule (you choose) No call in this role Pediatric and Obstetric cases only Extensive benefits included, along with tax advantaged structure Pediatric Fellowship is required**** Live where food, music, and culture define daily life-while enjoying professional stability and leadership impact. Please contact us to be considered by the hiring Manager. For further details and next steps please contact Sean at ************** or ************************. You may also reach Van Kalman at ************** ext. 102 or email at Van.Kalman@GoldMatchHealth. We will be happy to assist you. Note: This summary is not exhaustive and may include potential income, ranges, or benefit options. Please contact us for full details.
    $183k-296k yearly est. Easy Apply 28d ago
  • Medical Director - Ophthalmology

    Parexel 4.5company rating

    Medical director job in Baton Rouge, LA

    **Parexel** is in the business of improving the world's health. We do this by providing a suite of biopharmaceutical services that help clients across the globe transform scientific discoveries into new treatments. From clinical trials to regulatory, consulting, and market access, our therapeutic, technical, and functional ability is underpinned by a deep conviction in what we do. We believe in our values, Patients First, Quality, Respect, Empowerment & Accountability. **Parexel is looking for a Medical Director with a very strong background in Ophthalmology to join our Global Medical Sciences team.** **The role can be based remo** t **ely in the US or Canada.** The Medical Director is a medical expert with specialized therapeutic expertise and some experience across indications, clients and drug development. They initiate and maintain medical and consultative relationships with clients, consult on early engagement and pre-award efforts and serve as a medical monitor for contracted projects. The Medical Director may take on leadership roles by participating in initiatives, mentoring junior MDs and/or, where appropriate, managing a team of physicians. Primary activities will focus on **Medical Monitoring Delivery & PV Support** . The medical monitor will independently deliver all medical support required for successful delivery of the projects according to contracted agreement with the sponsor (i.e., tasks and time per task contracted) and according to the assigned role (Global Lead Physician or Regional Lead Physician). **Medical Expertise** and experience in **Ophthalmology** is essential to the medical monitor role and will be manifested in high quality consultation on protocol development or drug development programs, medical review of various documents, collaboration on internal therapeutic area meetings, training module development, white papers, slide sets, publications etc. **Client Relationship Building & Engagement,** including soliciting and addressing client feedback and suggestions regarding medical study-related activities, are core skills required of the medical monitor. **Business Development:** the medical monitor will provide medical expertise / leadership in Proposal Development Teams (PDTs) for client bid pursuit meetings. **Skills** + Excellent interpersonal skills including the ability to interact well with sponsor/client counterparts + Client-focused approach to work + Excellent time management skills + Excellent verbal and written medical communication skills + Excellent standard of written and spoken English + A flexible attitude with respect to work assignments and new learning + Ability to manage multiple and varied tasks with enthusiasm and prioritize workload with attention to detail + Willingness to work in a matrix environment and to value the importance of teamwork. **Knowledge And Experience** + Experience in clinical medicine (general or specialist qualifications) with Fellowship or specialty training in **Ophthalmology** , which is expected to be kept up to date. + A background in clinical aspects of drug development, including all aspects of Medical Monitoring and study design/execution, preferred + Clinical practice experience + Good knowledge of the drug development process including drug safety, preferred + Experience in Pharmaceutical Medicine, preferred + Experience leading, mentoring and managing individuals/ a team, preferred **Education** + US Board certified in **Ophthalmology** or Canadian equivalent + Experience as a Physician in Industry or as a clinical trial investigator is required + Previous CRO experience is strongly preferred + Medically qualified in an acknowledged medical school with completion of at least basic training in clinical medicine (residency, internship) The ability to travel 15% domestically or internationally is required \#LI-LB1 \#LI-REMOTE EEO Disclaimer Parexel is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to legally protected status, which in the US includes race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
    $201k-281k yearly est. 12d ago
  • Field Medical Director, Oncology

    Evolent 4.6company rating

    Medical director job in Baton Rouge, LA

    **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** **Lead the Transformation in Oncology Care** At Evolent, we're redefining how care is delivered for individuals facing cancer. As a Performance Suite Medical Director in Medical Oncology, you will play a pivotal role in advancing value-based care models that prioritize clinical excellence, patient-centered outcomes, and system-wide impact. This role offers the opportunity to collaborate with top-tier clinicians, influence care pathways, and drive innovation in one of the most critical areas of health care. If you're passionate about making a measurable difference in oncology, this is your platform to lead with purpose. In this role, you will combine your clinical oncology expertise with a focus on **value-based strategy and transformation** . Unlike traditional medical review roles that emphasize volume throughput, this position integrates utilization management with collaborative engagement and innovation. **Core Responsibilities** + **Clinical Review & Peer Collaboration** + Serve as the physician reviewer for oncology cases that do not initially meet medical necessity criteria, applying evidence-based guidelines to ensure high-quality and cost-effective care. + Conduct peer-to-peer discussions with requesting oncologists-not only to explain determinations but to **partner in driving practice patterns aligned with value and quality outcomes** . + Support clinical reviewers as a subject matter expert and resource. + **Practice & Physician Engagement** + Actively participate in **engagement sessions with oncology practices** , sharing best clinical practices and supporting broader adoption of evidence-based pathways. + Foster trusted peer relationships with oncologists to encourage **sustainable behavior change** that improves patient outcomes. + Support practice-level transformation initiatives that reduce unwarranted variation and enhance quality. + **Internal Strategy & Value Initiatives** + Collaborate with Evolent's clinical leadership on the **design, build, and execution of new value initiatives in oncology** . + Provide input on innovation opportunities, clinical algorithms, and models of care that support transformation in specialty care. + Partner with operational and analytic teams to assess the impact of interventions and identify opportunities for continuous improvement. + Participate in audit processes to validate accuracy of advance payment model payouts, ensuring alignment with clinical documentation, performance metrics, and contractual expectations. + **Compliance & Quality** + Ensure all reviews and engagements align with URAC, NCQA, and internal quality standards. + Document peer interactions and clinical decisions in a timely and accurate manner. + Participate in training and inter-rater reliability processes. **Qualifications** + MD/DO/MBBS with board certification in **Medical Oncology** . + Minimum five (5) years' post-residency experience, with active clinical practice preferred within the past 2 years. + Current, unrestricted medical license (multiple state licenses preferred or willingness to obtain). + Demonstrated **leadership in practice transformation, value-based care, or clinical quality improvement** . + Strong communication, collaboration, and organizational skills, with proven ability to influence physician behavior. + Energetic, curious, and passionate about **shaping the future of oncology care delivery** . + Not under sanction or exclusion from Medicare/Medicaid programs. To ensure a secure hiring process we have implemented several identity verification steps, including submission of a government issued photo ID. We conduct identity verification during interviews, and final interviews may require onsite attendance. All candidates must complete a comprehensive background check, in-person I-9 verification, and may be subject to drug screening prior to employment. The use of artificial intelligence tools during interviews is prohibited and monitored. Misrepresentation will result in immediate disqualification from consideration. **Technical Requirements:** We require that all employees have the following technical capability at their home: High speed internet over 10 Mbps and, specifically for all call center employees, the ability to plug in directly to the home internet router. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations. **Evolent is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status.** **If you need reasonable accommodation to access the information provided on this website, please contact** ************************** **for further assistance.** The expected base salary/wage range for this position is $120-130/hr. This position is also eligible for a bonus component that would be dependent on pre-defined performance factors. As part of our total compensation package, Evolent is proud to offer comprehensive benefits (including health insurance benefits) to qualifying employees. All compensation determinations are based on the skills and experience required for the position and commensurate with experience of selected individuals, which may vary above and below the stated amounts. Don't see the dream job you are looking for? Drop off your contact information and resume and we will reach out to you if we find the perfect fit!
    $120-130 hourly 60d+ ago
  • Part-Time Medical Director for OTP Clinic

    Baart Programs 3.4company rating

    Medical director job in Hammond, LA

    Description Part-Time Medical Director - Addiction Medicine Opportunity - Northshore, LABAART Programs is looking for a Medical Director to lead our Medically Assisted Treatment programs. This individual provides patient care, medical evaluation, establishes dosing levels, and interacts as necessary with Federal, state, county & other regulatory bodies. The Medical Director trains & manages subordinate physician extenders and provides MAT services directly to patients. BAART is looking for a physician that is looking to make a difference in our patient's lives. Patient Care Responsibilities: Planning and supervising provision of treatment for patients (including regular review and notes in the patient's record) according to established CSAT and state guidelines with a strong emphasis on quality & customer service. Signs patient record notes Oversees patient care provided by physician extender, signs charts, dosing levels, etc., when applicable Admitting Patients for Methadone and Buprenorphine Treatment. Oversight of any patient site emergencies Physician will obtain a history and physical exam. Examination results to meet Federal and state guidelines and refers patient for care elsewhere when indicated (including appropriate follow up) Medical Director Responsibilities: Initiates, alters and terminates replacement narcotic therapy medications following strict protocols meeting the approval of Federal & state guidelines as well as current medical literature for patient care. Supervises the administration and dispensing of medications. Confers with patient's private physician as needed. Examines staff after on-the-job accidents or injuries as needed. Serves as a clinic in-service resource. Provides patient education specific to various disease processes within our scope of practice. Oversees the continuum of care process for patients. Maintains strict patient, employee, company and computer confidentiality. Minimum Qualifications: Current LA license Ability to prescribe methadone & buprenorphine Board eligible or certified in addiction medicine Minimum of 6 months experience in Addiction Medicine/MAT & 1-year of family practice required Satisfactory drug screen and background check. What to expect from us: BAART Programs a progressive substance abuse treatment organization is committed to the highest quality of patient care in a comfortable outpatient clinic setting. Our ultimate goal is to address the physical, emotional, and mental aspects of opioid use disorder to help each of our patients achieve long-term recovery and an improved quality of life. BAART Programs is committed to Equal Employment Opportunity (EEO) and to compliance with all Federal, State and local laws that prohibit employment discrimination on the basis of race, color, age, natural origin, ethnicity, religion, gender, pregnancy, marital status, sexual orientation, citizenship, genetic disposition, disability or veteran's status or any other classification protected by State/Federal laws
    $212k-304k yearly est. Auto-Apply 60d+ ago
  • Associate Director, Medical Omnichannel Data Scientist

    Otsuka America Pharmaceutical Inc. 4.9company rating

    Medical director job in Baton Rouge, LA

    **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
  • Manager, Medical Rebates Execution

    Cardinal Health 4.4company rating

    Medical director job in Baton Rouge, LA

    **_What Finance Operations contributes to Cardinal Health_** Finance oversees the accounting, tax, financial plans and policies of the organization, establishes and maintains fiscal controls, prepares and interprets financial reports, oversees financial systems and safeguards the organization's assets. Finance Operations is responsible for core financial operation processes. This can include customer and vendor contract administration; customer and vendor pricing, rebates, billing vendor chargeback research and reconciliation; processing vendor invoices and employee expense reports for payment; fixed asset accounting for book and tax records; cash application; and journal entries. + Demonstrates knowledge of financial processes, accounting policies, systems, controls, and work streams + Demonstrates experience working in a transnational finance environment coupled with strong internal controls + Possesses understanding of service level goals and objectives when providing customer support + Works collaboratively to respond to non-standard requests + Possesses strong organizational skills and prioritizes getting the right things done **_Responsibilities_** + Manage a team of Cardinal Health and Genpact individuals who oversee the entirety of the GPO Admin Fees and Rebates set up and report creation functions, including P&L accruals, rebate setups within SAP Vistex and ad hoc reporting for key internal and external stakeholders + Ensure GPO Admin Fees and Rebates are properly accounted for + Own first level review/approval responsibilities for non-standard rebate structures to ensure proper audit documentation is maintained and proper approvals are received + Oversee key rebate accuracy and timeliness CSLs and KPIs + Partner with cross-functional teams to research and resolve root cause issues impacting rebate accuracy or ability to set up Rebates and GPO Admin Fees timely; apply big picture knowledge to assess and interpret financial impact of process changes and resulting driver outcomes of GPO Admin Fee/Rebate set up changes + Foster a strong SOX internal control structure and seek opportunities for improvements, including build out of SOP processes and project development + Transform current payout and reporting process into Vistex implementation and go-forward build/upkeep + Develop plans for future systematic enhancements + Assist team with more complicated customer and transaction activities; oversee escalations to ensure closure in a timely manner + Partner with and be a thought-provoking leader to business partners across the organization to properly account for transactions, including but not limited to Sales, Legal, Finance, Pricing, Accounting and Contracting + Actively collaborate and support cross-functional team initiatives to improve customer experience, both internally and externally + Establish team and individual-oriented goals for growth and development **_Qualifications_** + Bachelor's Degree in Accounting, Finance or Business Management, preferred + 8+ years of professional experience in related field preferred, including but not limited to Accounting, Finance, or Audit + Accounting and Finance acumen + Ability to lead a new team and influence others + Knowledge with SAP and legal contracts (revenue recognition standards is a plus) + Data mining experience (relevant application tool experience is a plus) + Strong written and verbal communication skills + Process improvement oriented + Strong SOX/internal control understanding **_What is expected of you and others at this level_** + Applies comprehensive knowledge and a thorough understanding of concepts, principles, and technical capabilities to manage varied tasks and projects + Manages department operations, supervises professional employees, and ensures employees operate within guidelines + Develop team and individual development plan goals for direct reports + Participates in the development of policies and procedures to achieve specific goals + Recommends new practices, processes, metrics, or models + Works on or may lead complex projects of large scope, including leading offshore teams and working in conjunction with other CAH teams + Develops technical solutions to a wide range of difficult problems; solutions are innovative and consistent with organization objectives + Receives guidance on overall project objectives + Independently determines method for completion of new projects + Gains consensus from various parties involved + Acts as a mentor to less experienced colleagues **Anticipated salary range:** $105,100 - $135,090 **Bonus eligible:** Yes **Benefits:** Cardinal Health offers a wide variety of benefits and programs to support health and well-being. + Medical, dental and vision coverage + Paid time off plan + Health savings account (HSA) + 401k savings plan + Access to wages before pay day with my FlexPay + Flexible spending accounts (FSAs) + Short- and long-term disability coverage + Work-Life resources + Paid parental leave + Healthy lifestyle programs **Application window anticipated to close:** 12/28/2025 *if interested in opportunity, please submit application as soon as possible. The salary range listed is an estimate. Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidate's geographical location, relevant education, experience and skills and an evaluation of internal pay equity. _Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply._ _Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal_ _Opportunity/Affirmative_ _Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law._ _To read and review this privacy notice click_ here (***************************************************************************************************************************
    $105.1k-135.1k yearly 36d ago
  • Hospital Administrator

    Confidential-Home Health Care

    Medical director job in Baton Rouge, LA

    Job Description Hospital Administrator needed to lead a well-established, financially stable and well reputed 24 beds Adult Acute Psychiatric Hospital Inpatient and Outpatient programs located in Baton Rouge, LA. Apollo Behavioral Health Hospital established in June 2012 and moved into a newly constructed facility in Aug 2018, is a state-of-the-art facility conveniently located in the heart of Baton Rouge at the intersection of I-12 and Airline Highway. Salary: Starting base $100,000+/yr - DOE plus growth opportunity up to $300,000 Benefits: Health, dental & vision insurance 401K plan and profit-sharing plan Holiday pay & PTO Competitive salary Positive work environment This position will be responsible for the overall operation of the facility's programs according to approved policies, procedures, and standards. Works in conjunction with the Medical Director, DON and CEO to ensure that quality patient care is provided according to state and federal laws and regulations. Maintains the image of the facility in the local communities and in state and national organizations. Keeps the facility abreast of local, state, and national trends. RESPONDSIBILITIES: Serves as the liaison among the governing body, the professional advisor group, and the professional and business staff. Responsible for overall operation of all programs at IPF and OPF. Employs qualified personnel and provides for adequate staff education. Interviews, hires, supervises, evaluates, and terminates administrative staff. Ensures adequacy of all staff. Interprets policies and procedures for the Board of Directors, including the implications of proposed policies. Ensures the implementation of all policies and procedures. Promotes good community relations through involvement in community affairs and serving on related boards and committees. Investigates and resolves all complaints. Monitors the fiscal condition of the facility and ensures adequate resources. Quarterly evaluation of each department functioning and leadership functioning. Identify Strengths and Weaknesses, Identify the non-compliance issues, Establish Goals and Measure of Success. Assist with the LDH/TJC survey process and write corrective action plans. Promote positive culture within the company and motivate staff to be productive and do the right thing that they are hired for. Pro-active approach to problem solving and taking measures to avoid the crisis. Keep the programs running at FULL capacity. Expand the bed capacity from 24 beds to 48 beds or higher. Expand the Outpatient service lines and census beyond the building capacity. EDUCATION/EXPERIENCE REQUIREMENTS: Must have the following qualifications: Must have a baccalaureate degree in health care administration, nursing, social work, mental health, or equivalent experience Must have a master's degree in Nursing/Social Work/Mental Health/Business Administration. Must have at least three years full-time experience in hospital administration preferably administrator at a psychiatric hospital. Must have at least five years of progressively responsible management position in healthcare. RN/NP/LCSW/MBA license preferred.
    $46k-81k yearly est. 20d ago
  • Hospital Administrator

    Confidential-Apollo Behavioral Health Hospital

    Medical director job in Baton Rouge, LA

    Hospital Administrator needed to lead a well-established, financially stable and well reputed 24 beds Adult Acute Psychiatric Hospital Inpatient and Outpatient programs located in Baton Rouge, LA. Apollo Behavioral Health Hospital established in June 2012 and moved into a newly constructed facility in Aug 2018, is a state-of-the-art facility conveniently located in the heart of Baton Rouge at the intersection of I-12 and Airline Highway. Salary: Starting base $100,000+/yr - DOE plus growth opportunity up to $300,000 Benefits: Health, dental & vision insurance 401K plan and profit-sharing plan Holiday pay & PTO Competitive salary Positive work environment This position will be responsible for the overall operation of the facility's programs according to approved policies, procedures, and standards. Works in conjunction with the Medical Director, DON and CEO to ensure that quality patient care is provided according to state and federal laws and regulations. Maintains the image of the facility in the local communities and in state and national organizations. Keeps the facility abreast of local, state, and national trends. RESPONDSIBILITIES: Serves as the liaison among the governing body, the professional advisor group, and the professional and business staff. Responsible for overall operation of all programs at IPF and OPF. Employs qualified personnel and provides for adequate staff education. Interviews, hires, supervises, evaluates, and terminates administrative staff. Ensures adequacy of all staff. Interprets policies and procedures for the Board of Directors, including the implications of proposed policies. Ensures the implementation of all policies and procedures. Promotes good community relations through involvement in community affairs and serving on related boards and committees. Investigates and resolves all complaints. Monitors the fiscal condition of the facility and ensures adequate resources. Quarterly evaluation of each department functioning and leadership functioning. Identify Strengths and Weaknesses, Identify the non-compliance issues, Establish Goals and Measure of Success. Assist with the LDH/TJC survey process and write corrective action plans. Promote positive culture within the company and motivate staff to be productive and do the right thing that they are hired for. Pro-active approach to problem solving and taking measures to avoid the crisis. Keep the programs running at FULL capacity. Expand the bed capacity from 24 beds to 48 beds or higher. Expand the Outpatient service lines and census beyond the building capacity. EDUCATION/EXPERIENCE REQUIREMENTS: Must have the following qualifications: Must have a baccalaureate degree in health care administration, nursing, social work, mental health, or equivalent experience Must have a master's degree in Nursing/Social Work/Mental Health/Business Administration. Must have at least three years full-time experience in hospital administration preferably administrator at a psychiatric hospital. Must have at least five years of progressively responsible management position in healthcare. RN/NP/LCSW/MBA license preferred.
    $46k-81k yearly est. 60d+ ago
  • Administrator for Inpatient Rehab Hospital

    The Ball Hawk

    Medical director job in Hammond, LA

    Responsibilities will include oversight of hospital operations, financial management, and regulatory compliance. Leads the facility management staff and consultants in developing and working from a business plan that focuses on all aspects of facility operations, including setting priorities and job assignments. Monitors each department's activities, communicates policies, evaluates performance, provides feedback, and assists, observes, coaches and disciplines as needed. Oversees regular rounds to monitor delivery of nursing care, operation of support departments, cleanliness and appearance of the facility; moral of the staff; and ensures resident needs are being addressed. Develops positive relationships on behalf of the Company with government regulators, residents, families, area health care, physicians, and the community at large. Acts as a resource of information to the community related to health care issues. Exhibits positive customer service both to internal and external customers through the ongoing support and implementation of the Company's Health and Rehabilitation Services customer service initiatives and business objectives. Utilizes survey information to address areas of importance as defined by our customers. Ensures consultants and other support resources are appropriately utilized and a high level of interdepartmental teamwork is maintained. Maintain a working knowledge of and ensure compliance with all governmental regulations. Monitor Human Resources practices to ensure compliance with employment laws and company policies, and to ensure practices that maintain high morale and staff retention to include effective communication, prompt problem resolution, proactive supervisory practices, and maintaining a proactive work environment. Manage turnover and ensure current and future staffing through development of recruiting sources, and through appropriate selection, orientation, training, staff education and development. Develop and implement a marketing strategy for the facility that reflects service opportunities, competition, potential market area changes, and which maximizes census, payor mix, and ancillary revenues. Lead and monitor key staff and facility staff to play an active role in carrying out the marketing plan. Take initiative in evaluation, development and implementation of new business opportunities that meets the needs of the community and benefits the facility/Company. Comply with, support and enforce Company policies involving all safety and infection control procedures. Promote and understanding of and compliance with all rules regarding resident's rights; promote positive relationships with residents, visitors and regulators. Supervise, conduct and participate in department and facility education activities and staff meetings. Utilize the quality improvement process in all areas of facility operation. Qualifications Degree and/or experience in a Physical Therapy/Hospital/Nursing Home/Assisted Living Setting. Master's Degree preferred Five or more years of recent hospital therapy management and/or supervisory experience. Must have record of demonstrating leadership competencies and management style that exemplify clients values. Substantial knowledge of applicable State, Federal and local codes, regulations, laws and regulatory compliance process. Knowledge of current and emerging industry trends affecting health care and rehabilitation practice. Demonstrated excellent written and verbal communication skills, and leadership competencies. Must possess basic computer knowledge Keywords: Rehabilitation, Nursing, Speech Language Pathologist, Occupational Therapist, Physical Therapist, Case Management, Social Services. Additional Information All your information will be kept confidential according to EEO guidelines.
    $45k-81k yearly est. 1h ago
  • Clinical Manager (RN) Pediatrics /Full-time

    Christus Health 4.6company rating

    Medical director job in Denham Springs, LA

    If you think you are the right match for the following opportunity, apply after reading the complete description. The Clinical Manager is responsible for direction of clinical services in Pediatrics. Works closely with the Chief Nursing Executive and the Medical Staff leadership to develop, implement, and maintain clinical and educational programs that enhance the quality of care and achieve a high level of patient and provider satisfaction. Requirements MINIMUM QUALIFICATIONS: EDUCATION: Graduate of an accredited program for Registered Nursing. BSN preferred. CERTIFICATION/LICENSES: R.N. with current New Mexico State license. BLS, NRP and either PALS or ENPC certifications required. National certification in area of expertise is a plus. SKILLS: Strong clinical and leadership skills and previous management experience including experience in facilitating interdisciplinary team collaboration. Evidence of such experience should include: Strong nursing knowledge and clinical skills Effective communication skills (verbal and written) Strong analytical skills Ability to problem solve; ability to appropriately confront issues Ability to motivate others as individuals and as a team Ability to plan, organize, direct, and manage the activities of others Ability to effectively run meetings and to negotiate deadlines. Ability to communicate with a wide variety of audiences Experience in dealing with physicians on an administrative level and ability to work collaboratively with medical staff members and leadership EXPERIENCE: Minimum of 5 years experience in clinical role in women's services or pediatrics.Two years progressive management experience. NATURE OF SUPERVISION: -Responsible to: Chief Nursing Executive. ENVIRONMENT: - Bloodborne pathogen A Works in a clean, well-lighted, ventilated smoke-free environment. PHYSICAL REQUIREMENTS: Subject to stressful professional relationships. Working hours vary, with flexibility due to unexpected changes in schedule and emergencies. xevrcyc Requires the ability to speak, listen, develop and communicate written materials.
    $42k-57k yearly est. 2d ago
  • PCO Medical Director- UM - Full Time

    Centerwell

    Medical director job in Baton Rouge, LA

    **Become a part of our caring community and help us put health first** The Medical Director, Primary Care relies on medical background and reviews health claims. The Medical Director, Primary Care work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. 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. The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All work occurs with a context of regulatory compliance, and work is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand how to operationalize this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all submitted clinical records, prioritization of daily work, communication of decisions to internal associates, participation in care management and possible participation in care facilitation with hospitals. The clinical scenarios predominantly arise from inpatient or post-acute care environments. There are discussions with external physicians by phone to gather additional clinical information or discuss determinations regularly, and in some instances, these may require conflict resolution skills. An aspect of the role includes an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within their scope. The Medical Director may speak with contracted external physicians, physician groups, facilities, or community groups to support regional market care facilitation and priorities, which may include an understanding of Humana processes, as well as a focus on collaborative business relationships, value-based care, population health, or disease or care management. **Use your skills to make an impact** **Responsibilities** The Medical Director provides medical interpretation and determinations whether services provided by other healthcare professionals are in agreement with national guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) contracts. The ideal candidate supports and collaborates with other team members, other departments, Humana colleagues and the Regional VP Health Services. After completion of mentored training, daily work is performed with minimal direction. Enjoys working in a structured environment with expectations for consistency in thinking and authorship. Exercises independence in meeting departmental expectations and meets compliance timelines. **Required Qualifications** + MD or DO degree. + 5+ years of direct clinical patient care experience post residency or fellowship, which preferably includes some experience in an inpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age). + Current and ongoing Board Certification in an approved ABMS Medical Specialty as well as ABQAURP, or other boarddemonstratingadvanced training in transitions of care, quality assurance,utilizationmanagementand care coordination. + A current and unrestricted license in at least onejurisdictionand willing to obtainadditionallicense, ifrequired. + No currentsanctionfrom Federal or State Governmental organizations, and able to pass credentialing requirements. + Excellent organizational,verbaland written communication skills. + Evidence of analytic and interpretation skills, with prior experienceparticipatingin teams focusing on transitions of care, quality management,utilizationmanagement, case management, discharge planning and/or home health or post-acute services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other medical management organizations, hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management. + Utilizationmanagement experience in a medical management review organization, such as Medicare Advantage,managed Medicaid, or Commercial health insurance. + Experience with national guidelines such as MCG or InterQual. + Internal Medicine, Family Practice, Geriatrics, Hospitalist, Emergency Medicine clinical specialists + Advanceddegreesuch as an MBA, MHA, MPH + Exposure to value-based care, Public Health, Population Health, analytics, and use of business metrics. + Experience working with Casemanagersor Caremanagerson complex case management, including familiarity with social determinants of health. + The curiosity to learn, the flexibility toadaptand the courage to innovate. **Additional Information** Will report to the Director of Physician Strategy at Utilization Management. The Medical Director conducts Utilization review of the care received by members in an assigned region, market, member population, or condition type. May also engage in grievance and appeals reviews. May participate on project teams or organizational committees. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $223,800 - $313,100 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 12-31-2025 **About us** About Conviva Senior Primary Care: Conviva Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. As part of CenterWell Senior Primary Care, Conviva's innovative, value-based approach means each patient gets the best care, when needed most, and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral and financial needs that can impact our patients' well-being. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Centerwell, a wholly owned subsidiary of Humana, complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our full accessibility rights information and language options *************************************************************
    $223.8k-313.1k yearly 28d ago
  • Medical Director, Medical Management

    Highmark Health 4.5company rating

    Medical director job in Baton Rouge, LA

    This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and most current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and appropriateness of the requested treatment of service. Depending on the nature of the case, telephonic peer to peer discussions may be required. The incumbent ensures compliance to NCQA, URAC, CMS, DOH, and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member of the multidisciplinary team for case and disease management. They will advise the multidisciplinary team on cases, particularly high-risk cases, through the team structure. Additionally, the incumbent may be assigned special projects to help support and improve the care of our members **ESSENTIAL RESPONSIBILITIES** + Conduct electronic review of escalated cases against medical policy criteria, which may include telephonic peer to peer discussions, to determine medical necessity and appropriateness. Complete initial determination of cases, review of appeals and grievances, and other reviews as assigned. Compose clear and concise rationales for member and provider determination notifications all while adhering to required compliance standards (NCQA, URAC, CMS, DOH, and DOL regulations, etc.). Ensure that all aspects of the medical management process are consistent with community standards of care. + Participate as a member of the CMDM multidisciplinary team. Attend huddles and grand rounds. Advise multidisciplinary team on cases that require physician expertise. + Participate in protocol and guidelines development to ensure consistency in the review process. + Actively manage projects and/or participate on project teams that require a physician subject matter expert. + Other duties as assigned. **EDUCATION** **Required** + Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO) **Substitutions** + None **Preferred** + Master's Degree in Business Administration/Management or Public Health **EXPERIENCE** **Required** + 5 years in Clinical, Direct Patient care (hospital, outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed care industry **LICENSES AND CERTIFICATION** **Required** + Medical Doctor or Doctor of Osteopathic Medicine (DO) + Awarded Board Certification at least once in specialty recognized by the American Board of Medical Specialties or the American Osteopathic Association Specialty Certifying Boards + Active medical state licensure required. Additional specific state licensure(s) may be required based on business need. **Preferred** + None **SKILLS** + Critical Thinking + Case Management + Customer Service + Oral & Written Communication Skills + Collaboration + Listening + Telephone Skills + General Computer Skills + Clinical Software + Managed Care **Language (Other than English)** None **Travel Required** 0% - 25% **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** Position Type Office-Based Teaches / trains others regularly Occasionally Travel regularly from the office to various work sites or from site-to-site Rarely Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required No Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Rarely Lifting: 25 to 50 pounds Rarely **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._ **_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._ _As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._ _Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._ **Pay Range Minimum:** $170,000.00 **Pay Range Maximum:** $352,500.00 _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._ Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J272826
    $170k-352.5k yearly 14d ago
  • Field Medical Director , Radiology (Urology)

    Evolent 4.6company rating

    Medical director job in Baton Rouge, LA

    **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** Job Description As a FMD, Radiology you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients lives, in a non-clinical environment. You can enjoy better work- life balance on a team that values collaboration and continuous learning while providing better health outcomes. **Collaboration Opportunities:** + Routinely interacts with leadership and management staff, other Physicians, and staff whenever a physician`s input is needed or required. **What You Will Be Doing:** + Serve as the Physician match reviewer in Imaging cases, that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests when providers, clients, or state laws require specialty reviews to be completed by the subject matter expert. + Discusses determinations (peer to peer phone calls) with requesting physicians or ordering providers, when available, within the regulatory timeframe of the request and provides clinical rationale for standard and expedited appeals. + Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance (NCQA) guidelines. + Aids and acts as a resource to Initial Clinical Reviewers. + Ensures documentation of all communications with medical office staff and/or MD provider is recorded in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + Participates in on-going training per inter-rater reliability process. **Qualifications:** + MD/DO/MBBS + Minimum of five (5) years' experience in the practice of Medicine, post residency and Active Clinical practice within the last 2 years is preferred + Current, unrestricted clinical license in medicine or required specialty- + Obtaining and maintaining medical licenses in the state you reside, as well as, any license required per business needs + Active Board Certification by an accredited organization + Strong clinical, management, communication, and organizational skills + Energetic and curious with a passion for quality and value in health care + Computer Proficiency + Not under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified as an "excluded person" by the Office of Inspector General of the Department of Health and Human Services or the General Service Administration (GSA), or reprimanded or sanctioned by Medicare. + No history of a major disciplinary or legal action by a state medical board To ensure a secure hiring process we have implemented several identity verification steps, including submission of a government issued photo ID. We conduct identity verification during interviews, and final interviews may require onsite attendance. All candidates must complete a comprehensive background check, in-person I-9 verification, and may be subject to drug screening prior to employment. The use of artificial intelligence tools during interviews is prohibited and monitored. Misrepresentation will result in immediate disqualification from consideration. **Technical Requirements:** We require that all employees have the following technical capability at their home: High speed internet over 10 Mbps and, specifically for all call center employees, the ability to plug in directly to the home internet router. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations. **Evolent is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status.** **If you need reasonable accommodation to access the information provided on this website, please contact** ************************** **for further assistance.** The expected base salary/wage range for this position is $95-110/hr. This position is also eligible for a bonus component that would be dependent on pre-defined performance factors. As part of our total compensation package, Evolent is proud to offer comprehensive benefits (including health insurance benefits) to qualifying employees. All compensation determinations are based on the skills and experience required for the position and commensurate with experience of selected individuals, which may vary above and below the stated amounts. Don't see the dream job you are looking for? Drop off your contact information and resume and we will reach out to you if we find the perfect fit!
    $95-110 hourly 60d+ ago
  • Associate Director, Congress & Medical Education Strategy & Execution - Rare Disease

    Otsuka America Pharmaceutical Inc. 4.9company rating

    Medical director job in Baton Rouge, LA

    The Associate Director, Congress and Medical Education Strategy & Execution is responsible for executing and contributing to the global medical strategy and tactical implementation for congresses and medical education, and supporting Otsuka's non-promotional scientific communication initiatives across the diverse Rare Disease portfolio. This role leads scientific engagement through impactful congress planning & execution educational programs, and evidence-based content that support Otsuka's mission to improve patient outcomes through deep scientific understanding and collaborative partnerships. The Associate Director partners closely with global and regional cross-functional stakeholders - including Global Medical Affairs, Clinical Development, Global Integrated Evidence & Innovation (GIE&I) and Commercial, to ensure scientific alignment, operational excellence and consistency in Otsuka's external scientific exchange. **** **Key Responsibilities Include:** **Congress Strategy and Execution** + Manage execution and contribute to the development of comprehensive multi-year medical congress strategy for the relevant therapeutic area aligned with Otsuka's pipeline and product lifecycle stages (e.g., establishing and developing an emerging portfolio), including prioritization of key international and regional congresses, scientific communication objectives, symposia, booth presence, and internal/external engagement activities + Collaborate with Medical Strategy, Medical Communications, Field Medical and Medical Information to develop high-quality, scientifically rigorous presentation and materials; ensuring data dissemination plans are timely, consistent, and strategically aligned + Support scientific communication planning across global and regional teams to ensure consistent, data-driven communication objectives across congress activities + Partner with Medical Communications to coordinate Otsuka's scientific presence at congresses, including: + Abstract submissions and poster presentations + Oral presentations and late-breaking sessions + Sponsored symposia and educational sessions + Medical booth design and operations + Press activities and medical engagement + Support planning and execution of engagement with external experts and stakeholders (e.g. KOLs, Patient Advocacy Groups) before during and after congresses + Organize and facilitate investigator meetings and advisory boards in conjunction with congress + Coordinate opportunities for scientific exchange between Otsuka Medical Affairs personnel and external experts and stakeholders + Manage end-to-end aspects of congress planning activities and post-congress insight generation to maximize impact and inform future strategies + Implement innovative digital strategies to extend congress reach and engagement, including virtual and hybrid congress solutions + Establish KPIs for congress activities and implement systems to track and analyze performance + Conduct post-congress analysis toa assess impact and identify areas for improvement **Independent Medical Education (IME)** + Develop and implement the global medical education strategy for relevant therapeutic area in alignment with medical and objectives and strategy + Oversee the development of scientific exchange platforms, independent medical education (IME) initiatives to elevate disease and product knowledge globally + Partner with regional and local teams to ensure educational programs address unmet needs and comply with regional regulations and global standards + Identify, evaluate, and partner with external experts, medical societies and educational providers to ensure high-quality, unbiased scientific content delivery + Monitor educational impact through KPIs, metrics and insights **Cross-Functional Collaboration** + Act as a key contributor and subject matter expert for the relevant therapeutic area medical education and congress activities + Collaborate with Medical Affairs, Clinical Development, Global Integrated Evidence & Innovation (GIE&I), Regulatory, and Commercial teams to ensure scientific alignment and appropriate integration of new evidence into educational content + Provide guidance and mentorship to team members and vendors to ensure high standards of scientific integrity, external experts and stakeholder (e.g., KOL) experience and operational excellence + Create and manage congress budgets, ensuring cost-effectiveness and ROI and ensure compliant use of medical education and congress funding + Represent Global Medical Affairs in governance forums and cross-functional planning meetings + Ensure all congress and medical education activities comply with global and local regulatory requirements, Otsuka policies, data publication embargos and industry codes + Proactively identify and mitigate risks related to scientific exchange and external engagements based on Global Medical Affairs policies and SOPs + Consider technology and AI to support workflow improvement **Qualifications** **Education and Experience:** + Advanced scientific or medical degree (PharmD, PhD, MD, or equivalent) preferred + Extensive experience working within relevant therapeutic area, including engagement with specialized HCPs and evidence generation strategies + Additional business or communications training (MBA, MPH, etc.) preferred + 12+ years of experience in Medical Affairs; ~5 years focused on congress strategy and execution is preferred + Proven success managing matrixed & cross-functional global teams and external vendors + Demonstrated experience leading global congress strategy, IME programs, or scientific engagement + Proven track record of successful congress planning and implementation on a global scale including implementation of digital and virtual congress solutions + In-depth understanding of industry compliance, regulatory frameworks, and ethical considerations for scientific engagement **Skills and Competencies:** + Strategic and analytical thinker with the ability to translate complex science for a variety of audiences and anticipate trends and shape proactive congress and educational strategies + Excellent project management, communication (written and verbal), and stakeholder engagement skills + Collaborative and communicative, with ability excel at building and maintaining relationships with external stakeholders and experts (e.g. KOLs, scientific) + Financial acumen and experience managing large program budget + Ability to influence across matrixed teams and drive strategic initiatives **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 21d ago
  • Director of Laboratory Services

    Lighthouse Lab Services

    Medical director job in Baton Rouge, LA

    Job Description Lighthouse Lab Services has partnered with a large healthcare organization in the epicenter of Louisiana seeking a Director of Laboratory Services. This individual would be a part of their growing operation in Baton Rouge, LA. ABOUT BATON ROUGE, LA: Baton Rouge, Louisiana, blends Southern charm, cultural richness, and modern opportunity. With a cost of living well below national averages, residents enjoy affordable comfort and a vibrant lifestyle. The city's Cajun and Creole cuisine, lively music, and annual festivals celebrate its unique Louisiana heritage. Home to LSU and a growing research and technology hub, Baton Rouge offers strong professional and educational opportunities. From scenic riverfront trails to the energy of LSU game days, Baton Rouge is affordable, flavorful, and full of heart. It is a place where life moves to its own joyful rhythm. ABOUT THE CLIENT: For generations, the client has been a cornerstone of the community, adapting through historic advances in medicine, technology, and patient needs. The hospital has expanded access to care and simplified the healthcare experience, now offering more than 600 licensed beds across three campuses. From delivering newborns to providing compassionate hospice care, they deliver the full spectrum of healthcare services. Its acclaimed, award-winning cancer and heart programs, and network of clinics across the region reflect a steadfast commitment to comprehensive, patient-centered care for every stage of life. ABOUT THE ROLE: The Director of Laboratory Services is responsible for the overall operation and administration of the Laboratory including the employment of personnel who are competent to perform test procedures, record and report test results promptly and accurately and for assuring compliance with the applicable regulations. With oversight of strategic planning, direction and overall accountability all Laboratory Services, the Director of Laboratory Services independently makes decisions that could seriously affect the overall division and/or the hospitals financial and performance objectives and strategic results. They will actively participate in committees responsible for establishing related policies and procedures. They will develops oversee department budget, direct reports including managers, supervisors and staff to include responsibility for performance reviews, hiring, disciplinary actions and terminations. KEY RESPONSIBILITIES: Demonstrate courtesy and caring for each other, patients and their family, physicians, and the community. Take initiative in living our values and vital signs. Take initiative in identifying customer needs before the customer asks. Participate in teamwork willingly and with enthusiasm. Demonstrate respect for the dignity and privacy needs of customers through personal action and attention to the environment of care. Keep customers informed, answers customer questions and anticipate information needs of customers. Participate in Interdepartmental Rounding for the areas served. Practice diligence in fulfilling the regulatory and legal requirements of the position and department. Maintain accurate and reliable patient/organizational records. Maintain professional relationships with appropriate officials; communicate honesty and completely; behave in a fair and nondiscriminatory manner in all professional contacts. Set goals and action plans to achieve objectives. Complete assignments following accepted procedures and practices, even when workloads and demands are high. Adhere to high moral principles of honesty, loyalty, sincerity, and fairness (integrity). Utilize data to plan new products and services. Strive to continuously improve all aspects of the business operation through quality improvement initiatives. Assure the accuracy of data, work, or information and contributes ideas and suggestions to improve approaches, methodologies, and productivity. Utilize data to implement clinical and operational redesign efforts. Willingly participate in organization and/or department quality initiatives. Demonstrate effective time management to promote productivity and cost efficiency. Use material goods wisely, is conscious of the environment and is accountable for prudent use of our talents and financial resources. Develop appropriate budget(s) for areas of responsibility. Effectively manage budget(s) and continually monitor key cost areas. Invite input from others and share ownership and recognition. Inspire people by example and influence them to do and be their best. Inspirate and encourage teamwork. Consistently execute applicable company policies, rules and regulations. Establish clear work objectives that prioritize and focus on employee efforts. Staff work area with appropriate numbers of qualified employees. Allocate and delegate work effectively to make efficient use of resources and employee capabilities. Provide opportunities for skill development for employees. Delegate authority to supervisory and department(s) or areas of responsibility staff members. Provide direction and policy interpretation to managers. Encourage staff participation and communication in decision-making. Exhibit responsiveness to others in the organization at all levels. Assure that applicable accreditation standards and governmental regulations for areas of responsibility are continually met. Analyze services to determine means of improving efficiency, quality and cost effectiveness. Effectively plan the scope, emphasis and objectives of laboratory services. Effectively organize the Laboratory's operating systems. Effectively measure the performance and productivity of the department by means of quantitative profiling of factors such as procedures, and staff utilization. Establish and maintain communication with internal and external customers in order to ensure a timely response to new clinical service trends and program planning. Investigate and studies trends and developments in Laboratory practices and techniques. Actively participate in committees responsible for establishing related policies and procedures. Develop goals and objectives in consultation with Administration. Participate in space utilization/consolidation studies and analysis. Lead and direct the development, communication and implementation of effective growth strategies and processes. Develop recommended plans to maximize operational efficiencies. Demonstrate good planning in anticipating the replacement needs of Laboratory equipment. Knowledge of budget preparation and monitoring, and accreditation requirements. MINIMUM REQUIRED QUALIFICATIONS Bachelor's degree in medical technology, clinical laboratory, chemical, physical or biological science, or related field. Higher degree would be a plus. 5 years leadership level experience in Laboratory services preferred. MLS(ASCP) Certification preferred. Current Clinical Laboratory Scientist, Generalist, or Specialist license issued by the Louisiana State Board of Medical Examiners required. SHIFT, SALARY, BENEFITS: First shift M-F Salary starting in the $100Ks and depending on experience, education, etc Full, comprehensive benefits package. Generous PTO. Possible EOY performance based bonuses About Us: At Lighthouse Lab Services, we offer solutions to help start, grow, and run clinical laboratories. Our recruiting team has more than 22 years of proven success placing job seekers in positions ranging from entry-level Medical Technologists to seasoned Laboratory Directors. We recruit nationwide for permanent and travel positions with clients ranging from small hospitals to large reference laboratories. It is the policy of Lighthouse Lab Services to provide equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. In addition, Lighthouse Lab Services will provide reasonable accommodations for qualified individuals with disabilities. Lighthouse Lab Services|************|lighthouselabservices.com #LLS3
    $100 hourly 1d ago

Learn more about medical director jobs

How much does a medical director earn in Baton Rouge, LA?

The average medical director in Baton Rouge, LA earns between $148,000 and $368,000 annually. This compares to the national average medical director range of $143,000 to $369,000.

Average medical director salary in Baton Rouge, LA

$233,000

What are the biggest employers of Medical Directors in Baton Rouge, LA?

The biggest employers of Medical Directors in Baton Rouge, LA are:
  1. Humana
  2. Evolent Health
  3. Highmark
  4. Sumitomo Corporation
  5. Centerwell
  6. UnitedHealth Group
  7. CVS Health
  8. Parexel International
  9. Goldmatch
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