The Medical Director is responsible for providing clinical leadership within Sentara Health Plans, aligned to one or more plans. Accountable for monitoring utilization, case management and quality outcomes. The Medical Director collaborates with the Sentara Health Plans Chief Medical Director, Senior Medical Director(s) and Clinical Care Services (CCS) teams to establish, implement, and evaluate effectiveness of clinical programs to support members and meet the department goals. Medical Director activities further include support of the CCS nurses, Government services nurses, Pharmacy staff, Population Health and Quality Improvement Teams. Lastly, Medical Directors interact externally with network physicians, vended program clinical leaders, and government program leaders as required to improve the quality of clinical outcomes, cost efficiency and patient/member experience with the Health Plan and Health Systems with which we contract.
Physical Location
Optima Health - Va Bch
Department Number and Name
706002372 Clinical Care Services Admin
Employment Status
Full time
Shifts
First (Days)
Job Posting
Optima Healthcare, the health plan division of Sentara, is recruiting a Medical Director to join its team. Qualified candidates will have experience working as either a Neurologist or a Cardiologist. As Medical Director, provide utilization management and develop programs. Health plan experience preferred or utilization management experience as a provider. Leadership management experience required. The Medical Director is a Remote position in one of the following US states; VA, NC, MD, FL, NV, WY, SD, WA, IN, TN, GA, SC, TX, WV, WI.
Required Education
Doctor of Medicine
Experience
Required: Clinical Practice - 5 years, Performance Improvement - Previous experience, Population Management - Previous experience, Project Management - Previous experience
Preferred: None, unless noted in the "Other" section below
Licenses and Certifications
Required: Medical Doctor
Preferred: None, unless noted in the "Other" section below
Skills
Required: Communication, Complex Problem Solving, Leadership
Preferred: None, unless noted in the "Other" section below
Other
Board certification required. Masters level degree in Medical Management, Business Administration or Public Health preferred. Medicaid, including long term services and support, and/or Medicare, including D-SNP, experience preferred/
City
Virginia Beach, VA
Job Category
Health Plan, Professional/Management, Talroo-Health Plan, Talroo-Leadership
Sentara Healthcare celebrates a 130-year history of innovation, compassion and community benefit. Based in Norfolk, VA, Sentara is a diverse not-for-profit family of 12 hospitals, an array of integrated services and a team of nearly 30,000 strong on a mission to improve health every day. This mandate is pursued through a disciplined strategy to achieve Top 10% performance in key measures through shared best practices, transformation of primary care through clinical integration and strategic growth that adds value to the communities we serve in Virginia and North Carolina.