Job Description
JOB SUMMARY:
The Associate Medical Director provides support for Community Health Choice's medical management programs. This includes performing medical necessity reviews, with peer-to-peer interactions as needed; appeals of adverse determinations; some clinical input and oversight for Care (Disease) Management, Quality Improvement, Credentialing, and Preventive Medicine programs; working with Provider Relations to maintain and improve relationships with the provider community; and other duties as assigned by the Senior Vice-President of Medical Affairs.
MINIMUM QUALIFICATIONS:
- Education/Specialized Training/Licensure: MD or DO Degree and Licensure in the State of Texas, Completion of Residency and Board Certification with preference for the Primary Care Specialties; master's degree in public health, Business Administration or Medical Administration preferred.
- Work Experience: 5 years clinical experience with 5 years of administrative experience in management of a private or group practice, facility, or other similar administrative experience such as physician reviewer or medical director in a facility or health plan.
Job Tags
Work experience placement, Private practice,