Medical Director
Company: Maximus
Location: Raleigh
Posted on: January 12, 2021
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Job Description:
Job Description SummarySUMMARYThe Medical Director supports
projects within Maximus's Clinical Services Division, which
performs a wide array of clinical assessment services for
individuals with physical and/or mental disabilities seeking
Medicaid-funded services and supports. The Medical Director serves
as the project's chief medical expert. The Medical Director
provides consultation and training to project leadership and
Registered Nurse (RN) reviewers to ensure all clinical reviews
adhere to standards set forth in law and regulation and
expectations set by the client and executive leadership. The
Medical Director reports to the Project Director.ESSENTIAL
FUNCTIONS1. Provide consultation as needed to clinical review teams
regarding complex cases, as well as mediation and appeals cases.2.
Direct quality assurance oversight of nurse and physician work
products. 3. Provide advice and counsel to the client as
directed.4. Drive innovative solutions to include automation to
ensure cutting edge strategies & implementation of best practices
within our industry.5. Direct the development of training materials
for nurses and physicians.ACCOUNTABILITY* Maintains primary
responsibility for ensuring customer satisfaction, resolving
compliance issues, accountability for profit & loss and adherence
to operational budgets with assigned contracts.JOB
REQUIREMENTSKnowledge, Skills & Abilities* Ability to demonstrate
not less than two years' experience in a management role with
oversight of quality assurance or medical management functions,
including disability review/evaluation and evidence-based medicine
research or application.* Ability to work effectively in a
"hands-on" management role, motivating staff through variety of
communications vehicles to include remote working when necessary.*
Assist program staff in consistent interpretation of relevant all
federal and state-specific criteria and guidelines * Direct and
control the activities of a broad functional area through several
department managers within the company.* Has overall control of
planning, recommending and implementing changes to methodology and
standards for performance.* Work on complex issues where analysis
of situations or data is utilized to accurately drive performance
decisions and/or company NC business trajectory.* Participate in
corporate development of methods, techniques and evaluation
criteria for projects, programs, and people.* Regularly interact
with executives and/or major customers.* Excellent organizational,
interpersonal, written, and verbal communication skills.* Ability
to successfully execute many complex tasks
simultaneously.EducationDoctorate of Medicine, board-certified and
licensed to practice medicine in North Carolina and meet stringent
credentialing standards. Expertise in North Carolina Medicaid and
standards of care strongly preferred.ExperienceThe job requires
seven (7) years of experience managing operations, preferably in
Medicaid-funded healthcare program, mental health, or a related
field. Essential Duties and Responsibilities:- Direct the
development of training materials for nurses and physicians.-
Oversee--quality assurance--of nurse and physician work product.-
Provide advice and counsel to the client as directed.Minimum
Requirements:- Direct and control the activities of a broad
functional area through several department managers within the
company.- Has overall control of planning, staffing, budgeting,
managing expense priorities, and recommending and implementing
changes to methods.- Work on complex issues where analysis of
situations or data requires an in-depth knowledge of the company.-
Participate in corporate development of methods, techniques and
evaluation criteria for projects, programs, and people.- Ensure
budgets and schedules meet corporate requirements.- Regularly
interact with executives and/or major customers.- Interactions
frequently involve special skills, such as negotiating with
customers or management or attempting to influence senior level
leaders regarding matters of significance to the organization.-
Report to Senior Director or VP level. MAXIMUS Introduction Since
1975, Maximus has operated under its founding mission of Helping
Government Serve the People, enabling citizens around the globe to
successfully engage with their governments at all levels and across
a variety of health and human services programs. Maximus delivers
innovative business process management and technology solutions
that contribute to improved outcomes for citizens and higher levels
of productivity, accuracy, accountability and efficiency of
government-sponsored programs. With more than 30,000 employees
worldwide, Maximus is a proud partner to government agencies in the
United States, Australia, Canada, Saudi Arabia, Singapore and the
United Kingdom. For more information, visit
https://www.maximus.com. EEO Statement: Active military service
members, their spouses, and veteran candidates often embody the
core competencies Maximus deems essential, and bring a resiliency
and dependability that greatly enhances our workforce. We recognize
your unique skills and experiences, and want to provide you with a
career path that allows you to continue making a difference for our
country. We're proud of our connections to organizations dedicated
to serving veterans and their families. If you are transitioning
from military to civilian life, have prior service, are a retired
veteran or a member of the National Guard or Reserves, or a spouse
of an active military service member, we have challenging and
rewarding career opportunities available for you. A committed and
diverse workforce is our most important resource. Maximus is an
Affirmative Action/Equal Opportunity Employer. Maximus provides
equal employment opportunities to all qualified applicants without
regard to race, color, religion, sex, sexual orientation, gender
identity, national origin, protected veteran status or disabled
status.
Keywords: Maximus, Raleigh , Medical Director, Executive , Raleigh, North Carolina
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