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Geisinger

Lock Haven, Pennsylvania

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South Texas Health System

MCALLEN, Texas

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Kindred Hospitals

Baldwin Park, California

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Orlando, Florida

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Durham, North Carolina

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Akron Children's - Physician Recruitment

Boardman, Ohio

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Irving, Texas

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Scranton, Pennsylvania

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South Texas Health System

MCALLEN, Texas

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Ocala, Florida

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State College, Pennsylvania

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Harrisburg, Pennsylvania

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DENISON, Texas

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Los Angeles, California

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South Texas Health System

MCALLEN, Texas

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South Texas Health System

EDINBURG, Texas

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Denver, Colorado

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Holtz Children's Hospital/UM Miller School of Medicine/Jackson Health System

Miami, Florida

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Baylor Scott & White Health

Highland Park, Texas

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University Park, Texas

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Mary Washington Healthcare

Fredericksburg, Virginia

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Baylor Scott & White Health

Irving, Texas

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Penn State Health

Camp Hill, Pennsylvania

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Baltimore, Maryland

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Medical Director Health Plan
JOB SUMMARYResponsible for managing Health Plan medical costs and assuring appropriate health care delivery for plans and members. Is accountable to provide professional leadership and direction in the utilization/cost management (UM) and clinical quality improvement (QI) of the Health Plan, as measured by benchmarked UM and QI goals. Works collaboratively as a clinical resource to other plan functions that interface with medical management such as provider relations, member services, benefits, claims management, etc. Carries out medical policies at the Health Plan consistent with NCQA and other regulatory bodies.ESSENTIAL FUNCTIONS OF THE ROLEIdentify opportunities for corrective action plans to address issues and improve plan and network man


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