Medical Management Director directs and oversees the operations and strategic planning of the organization's medical management initiatives and programs. Establishes case management, utilization review, quality and outcome management, and community education programs to provide high quality, cost effective health care services. Being a Medical Management Director develops and implements clinical guidelines for care designed to improve outcomes while managing costs. Requires a bachelor's degree. Additionally, Medical Management Director typically reports to top management. The Medical Management Director typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. To be a Medical Management Director typically requires 3+ years of managerial experience. (Copyright 2024 Salary.com)
Medica's Medical Director of Quality and Care Management supports the Clinical Services team via quality improvement activities including but not limited to collaborating with quality teams to improve the care received by our members as judged by HEDIS performance, state Medicaid programs, and other established quality measurement standards.
In support of the Senior Medical Director for Quality, Care Management and Public Policy, this enterprise-wide role requires the ability to actively represent clinical perspectives and provide thought leadership in driving new initiatives to engage providers and members to measurably improve quality performance. The Medical Director for Quality and Care Management will also provide clinical leadership for provider and organization credentialing as Chair of the Medica Credentialing Committee, requiring the ability to lead a diverse group of physician committee members towards consensus decisions.
Key Accountabilities:
This role requires forming productive relationships in leadership dyads with both clinical and non-clinical counterparts, and the ability to respectfully interact with internal and external stakeholders at all levels.
Qualifications:
Preferred Experience:
Skills and Abilities:
This position is a Remote role. The employee must be located in any state in which Medica is an employer and will work remotely 100% of the time.
The full salary range for this position is $196,000 - $336,000. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data. In addition to base compensation, this position may be eligible for incentive plan compensation in addition to base salary. Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees.
The compensation and benefits information is provided as of the date of this posting. Medica's compensation and benefits are subject to change at any time, with or without notice, subject to applicable law.
Medica's commitment to diversity, equity and inclusion (DEI) includes unifying our workforce through learning and development, recruitment and retention. We consistently communicate the importance of DEI, celebrate achievements, and seek out community partnerships and diverse suppliers that are representative of everyone in our community. We are developing sustainable programs and investing time, talent and resources to ensure that we are living our values. We are an Equal Opportunity/Affirmative Action employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.