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Medical Director - REMOTE PART-TIME in Orlando, FL at KEPRO

Date Posted: 2/17/2018

Job Snapshot

Job Description

KEPRO is a rapidly growing national qualityimprovement and care management organization. We work to ensure that over 1billion people receive the right care, at the right time, in the right setting. 



MEDICAL DIRECTOR

HCHCP MedicalDirector Requirements

  •    Maintain a local presence in the Orlando/CentralFlorida area.  Individual performingHCHCP MD functions must be a Florida licensed physician who will be available as a Consultant to a Health Plan to help them drive down costs and focus efforts on high dollar procedure/expenses and for monthly meetings.
  •     Requires current Florida licensure and boardcertification in his/her specialty.
  •     Accessible to HCHCP management staff and NetworkMedical Directors on an as needed basis to discuss reports, recommendations anddisease state management issues.
  •     Attendance require at monthly HCHCP medicalsub-committee and Network Medical Director’s meetings.
  •     Claims Analysis – Collaboration with KEPROanalytics team to review claims and make policy recommendations.
  •     HEDIS consultation and policy recommendations

QUALIFICATIONS


    • M.D. or D.O. with active, non-restricted Florida license/registration
    • Must be Board certified in Family Medicine or Internal Medicine
    • Minimum 2 years’ experience in State Medicaid programs with clinical care processes and outcomes, clinical guidelines, medical economics research, particularly the evaluation of medical utilization, population-based care practices, and provider billing practices. 
    • Minimum 3 years’ experience with UM, CM/DM
    • MUST HAVE EXPERIENCE WITH INTERQUAL or MILLIMAN
    • MUST HAVE HEALTH PLAN EXPERIENCE
    • Working knowledge of Federal, State and private health related activities.
    • Adaptable with strong collaborative management style, a creative thinker with high energy and enthusiasm, and a team player who promotes the concepts of people working together. Ability to adapt to frequently changing work parameters. 
    • Must be willing to travel to Tampa to support a standing meeting with all Health Plan Medical Directors - 3 hr meeting every other month.


KEPRO offers challenging careers, excellentbenefits and opportunities for advancement.  For consideration, pleasesubmit resume and cover letter with salary requirements. Only thosecandidates identified for an interview will be contacted. No PhoneCalls Please.  Visit our website at www.kepro.com for more informationon the KEPRO Family of Companies.  

 EOE AAM/F/Vet/Disability

KEPROis an E-Verify employer. E-Verify is an internet based system operated by theDepartment of Homeland Security (DHS) in partnership with the Social SecurityAdministration (SSA) that allows participating employers to electronicallyverify the employment eligibility of their newly hired employees in the UnitedStates.



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