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Company: Molina Healthcare
Location: Columbus, OH
Career Level: Mid-Senior Level
Industries: Healthcare, Pharmaceutical, Biotech

Description



Job Summary Bring your physician leadership, UM and Medical Director experience and commitment to quality to our Ohio health plan. You will provide guidance to staff, be responsible for day-to-day operations of the Medical Affairs department, and represent the plan at state regulatory agency meetings.

Responsibilities:
• Assists in recruitment, hiring and training of staff as needed.
• Analyzes data and identifies medical cost savings and quality improvement opportunities.
• Accounts for regulatory and accreditation performance of assigned team and responds to inquiries, issues and complaints from government and accreditation regulators.
• Directs the team in providing physician leadership and expertise in the performance of prior authorization, inpatient concurrent review, discharge planning, case management and interdisciplinary care team activities.
• Ensures that authorization decisions are rendered by qualified medical personnel, without hindrance due to fiscal or administrative incentives

Qualifications

Job Qualifications

Required Education
• Doctorate Degree in Medicine
• Board Certified or eligible in a primary care specialty
Required Experience
• 10+ years relevant experience, including:
• 5+ years clinical practice
• 2 years previous experience as a Medical Director
• 3 years experience in Utilization/Quality Program management
• 2+ years HMO/Managed Care experience
• Current clinical knowledge
• Experience demonstrating strong management and communication skills, consensus building and collaborative ability, and financial acumen
• Knowledge of applicable state, federal and third party regulations
Required License, Certification, Association
• Current State Medical License without restrictions (free of sanctions from Medicaid or Medicare)
• Current Drug Enforcement Agency Certificate
Preferred Education
Master's in Business Administration, Public Health, Healthcare Administration, etc.
Preferred Experience
• 12+ years relevant experience
• Peer Review, medical policy/procedure development, provider contracting experience.

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.


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