Clearlink Partners is an industry-leading independent clinical and operational consultancy specializing in total cost of care. We help managed care organizations, health plans, providers, and health systems improve enterprise-wide alignment and navigate a dynamic healthcare ecosystem.
Medical Director Overview:
The medical director will improve quality of care and access to care for vulnerable populations. Physician will have an opportunity to lead and drive special projects and initiatives as a daily part of this role.
Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities.
Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services.
Assists Chief Medical Officer in planning and establishing goals and policies to improve quality and cost-effectiveness of care and service for members.
Provides medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate, and accreditation requirements.
Identifies utilization review studies and evaluates adverse trends in utilization of medical services, unusual provider practice patterns, and adequacy of benefit/payment components.
Identifies clinical quality improvement studies to assist in reducing unwarranted variation in clinical practice in order to improve the quality and cost of care.
Interfaces with physicians and other providers in order to facilitate implementation of recommendations to providers that would improve utilization and health care quality.
Reviews claims involving complex, controversial, or unusual or new services in order to determine medical necessity and appropriate payment.
MD or DO LIcensed in Texas or Compact State
Board certified preferable in a primary care specialty (Internal Medicine, Family Practice, Pediatrics or Emergency Medicine).
Must be an actively practicing physician.
Course work in the areas of Health Administration, Health Financing, Insurance, and/or Personnel Management is preferred
Board Certification through American Board Medical Specialties. - Current medical license
Benefits of Joining Our Growing Team:
Clearlink Partners is a rapidly growing Consulting and Services organization looking for talented, innovative, and committed people.
Highly competitive salaries and benefit plans that include: Paid Time Off (PTO) including vacation time allowances for sick time, Health, Dental, Vision Plan options (including options for Health Savings Accounts and Flexible Spending accounts), eligibility for performance bonuses or incentives (depending on role), access to Short Term and Long Term Disability Plans and Life Insurance Plans, 401k retirement savings plan.
Our salaried employees are eligible for Medical benefits on day #1 and are FREE (zero premium) for the employee only (additional cost for others on your medical plan).
EEO Statement: It is Clearlink Partners policy to provide equal employment opportunity to all employees and applicants for employment without regard to race, sex, sexual orientation, color, creed, religion, national origin, age, disability, marital status, parental status, family medical history or genetic information, political affiliation, military service or any other non-merit based factor in accordance with all applicable laws, directives and regulations of federal, state and city entities.