Associate Medical Director (.5 Part Time)

South Country Health Alliance has an immediate need for an Associate Medical Director for our Medford office.

The Associate Medical Director (.5 Part Time) provides leadership, professional/clinical support, and expertise in areas of focus for designated programs and services of South Country Health Alliance. This position allows the flexibility of working remotely with the high level of engagement, collaborative culture, and purpose of being a part of a team helping make a difference.

The Associate Medical Director is responsible for collaborating with designated teams and departments to ensure the delivery of quality affordable healthcare services and may be involved in designated cross functional activities as assigned that require a physician’s knowledge and expertise to support the role and function of the Medical Director’s responsibilities.

Requirements include a current unrestricted medical license in Minnesota as a Doctor of Medicine (M.D.) or Doctor of Osteopathic Medicine (D.O.) with a minimum of five (5) years medical practice experience.

Board Certification in a specialty recognized by the American Board of Medical Specialties (ABMS) is also required as well as knowledge of managed healthcare systems, medical quality assurance, quality improvement, risk management, and the primary care model.

One to two years of health plan experience is highly desirable.

South Country offers a full range of comprehensive benefits and competitive pay. Salary for this position is negotiable.

POSITION DESCRIPTION

Position Title: Associate Medical Director

Dept: Medical Director

Reports To: Medical Director

Date: 4/1/2024

Skill Sets:Experience and demonstrated success developing and leading teams. Proven ability to assess needs, design and implement programs and evaluate results. Adept in staying current with emerging trends in health care especially as related to the designated area of focus. Ability to effectively manage multiple projects and priorities. Ability to build positive relationships and work collaboratively, both internally and externally. Possess exceptional interpersonal, oral, and written communication skills as well as excellent organizational, analytical, and problem-solving skills. Ability to maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).

Education/Experience:

Education/Experience: Required: Minimum of 5 years medical practice experience. Current unrestricted medical license in Minnesota as a Doctor of Medicine (M.D.) or Doctor of Osteopathic Medicine (D.O.) is required and verified throughout employment at South Country Health Alliance. Board Certification in a specialty recognized by the American Board of Medical Specialties (ABMS). Knowledge of managed healthcare systems, medical quality assurance, quality improvement, risk management, and the primary care model required.

Preferred: One to two years health plan experience is highly desirable. Working knowledge of Medicaid and Medicare benefit guidelines. Experience working with state, federal, and third-party regulations. Experience and knowledge of Quality Accreditation Standards (NCQA/HEDIS). Primary Care Specialty.

Primary Function:

The Associate Medical Director provides leadership, professional/clinical support, and expertise in areas of focus for designated programs and services of South Country Health Alliance. The Associate Medical Director is responsible for collaborating with designated teams and departments to ensure the delivery of quality affordable healthcare services. The Associate Medical Director may be involved in designated cross functional activity as assigned by the Medical Director that requires a physician’s knowledge and expertise to support the role and function of the Medical Director’s responsibilities.

Essential Accountabilities

1. Provides clinical input and physician leadership in team settings into the design and optimal function of existing and future health plan services, programs, policies, and procedures.

2. Assists with and becomes experienced in various ongoing activities of the Medical Director including, but not necessarily limited to prior authorization and utilization management, credentialing review, grievance, and appeal review, among others.

3. Participates in and acquires a working knowledge of various committees including quality assurance, utilization management, DUR, Medical Coverage Policy, PBM Pharmacy and Therapeutics, Credentialing, MN DHS Universal Pharmacy Policy, and Contract Review.

4. Interacts with all departments of the organization, when indicated, to improve quality, access, cost, and outcomes that members value.

5. Other duties as assigned.

Qualification Requirements:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Language Skills:

Must be able to read and write in English. Strong listening, verbal, presentation, and written communication skills; Advanced language skills including inquiry skills to assure clear issue identification; Ability to articulate complex issues effectively to a variety of audiences; Writing that is clear and to the point; Chooses the appropriate method of communication to meet customer and organizational needs.

Mathematical Skills:

Advanced mathematical skills. Basic understanding of quality and financial data reporting.

Accuracy:

Considerable accuracy and dependability required. Must be attentive to the critical impact of policies, decisions and program design on our members, providers, and the overall image of the organization.

Reasoning Ability:

Must understand cause and effect relationships and be able to draw conclusions from data, regulatory requirements, and past practice; Requires the use of keen judgment on involved and complex issues; Devises methods and procedures to meet unusual conditions and makes original contributions to the solution of very difficult problems; Demonstrated complex problem-solving skills with effective follow through to address highly critical issues; Ability to think strategically.

Physical demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to talk or listen. The employee frequently is required to sit, sometimes for extended periods of time. The employee is occasionally required to stand, walk; kneel; use hands to finger, handle, or feel objects, tools, or controls; and reach with hands and arms.

The employee must rarely lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception, and the ability to adjust focus.

Work Environment:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The noise level in the work environment is usually low to moderate.

Travel Requirements:

Travel is not expected on any regular basis, however, may be requested on occasion.

Contacts

Executive Management; Development of effective teamwork and efficient operations; Interaction could involve occasional presentation of new methods, programs, or procedures to improve current practices or meet changing conditions or settle controversial issues.

Financial Impact

This position has limited financial responsibility; Develops programs and services where results can be measured.