Summary

Reporting to the Senior Medical Director, the Medical Director Program Manager is responsible for ensuring the efficient operations for the Senior Medical Director and facilitating UM clinical and administrative processes for the Senior Medical Director.

Duties and Responsibilities

· Implement and monitor project progress, establish well-defined deadlines, and maintain proactive communication with the Senior Medical Director, the Senior Medical Director team, and TMs to ensure the timely and successful completion of tasks and projects

· Maintain the Senior Medical Director's calendar, schedule appointments, and coordinate meetings with internal and external stakeholders

· Manage email correspondence, answer phone calls, monitor and track voicemails, and serve as a primary point of contact for the Senior Medical Director, including peer-to-peers

· Monitor and track peer-to-peer requests for the Senior Medical Director and the Senior Medical Director team and relay outcomes to the appropriate sub-teams: IP, OP, NOA

· Assist in the planning and coordination of meetings, preparing training materials, Senior Medical Director IRR Questionnaires, and tabulating results for UM compliance preparing agendas, taking minutes, and disseminating meeting materials

· Organize, maintain, and archive important documents and records, ensuring they are easily accessible

· Translate medical and clinical data, as provided by the Senior Medical Director, into easily understandable reporting and analysis languages, ensuring that key insights and findings are accessible to a broader audience within the organization

· Enter and maintain data related to Senior Medical Director's activities, review invoices, generate reports, and assist in data analysis as required

· Create, format, and proofread documents, presentations, and reports as directed by the Senior Medical Director

· Assist in project management tasks, including tracking progress, coordinating team efforts, and ensuring deadlines are met

· Gather medical records: authorization history or notes as requested by the Senior Medical Director for further review as needed for auth adjudication or PQI cases

Minimum Job Requirements

· Bachelor's Degree in a relevant field, such as Healthcare Administration, Public Health, Nursing, or a related healthcare discipline, along with demonstrated project management skills and clinical knowledge

· 2 years of project-based and/or administrative experience work experience in the healthcare field

· Proficiency in medical terminology and coding, with the ability to interpret and apply coding systems such as ICD-10, CPT, and HCPCS for support of clinical review and documentation purposes

· Demonstrated experience in crafting formal documents and policies

· Demonstrated experience in supporting data-driven decision

Skill and Abilities

· Proficient in using Microsoft Excel, PowerPoint, and Word; familiarity with EZ-CAP® is advantageous

· Strong multitasking ability, adept in fast-paced environments, exceptional organizational skills, and time management

· Excellent written and verbal communication; detail-oriented with a focus on accuracy

· Handles confidential information with discretion; possesses strong interpersonal skills and a professional demeanor

· Demonstrates adaptability and a proactive approach to problem-solving