Associate Medical Director - UM PT

FIND YOUR FUTURE We're excited about the potential people bring to our organization.

You can grow your career here while enjoying first-class perks, benefits and a culture that fosters growth, innovation and collaboration. *** Will consider applicants from NY, FL, NC, SC, TX *** Overview The Associate Medical Director, Utilization Management is responsible for assisting the Medical Director in the oversight of Utilization Management (UM) programs and will support the development and maintenance of these programs, with focus on clinical accuracy and appropriateness.

The Associate Medical Director (AMD) will assist the Medical Director in the efforts to develop strategic corporate direction / focus for UM programs.

The AMD will support the SVP, Healthcare Services in preparing annual metrics of results of UM programs.

The AMD contributes to the provision of measurable outcomes for prior authorization, step therapy and quantity limit programs.

The AMD will collaborate with internal teams to support corporate HEDIS initiatives with appropriate clinical program development.

The AMD is expected to work closely with clinical program development teams, clinical service operations and clinical quality committees and provide clinical guidance and oversight to these areas.

The AMD shall also serve on IH committees as directed by the Medical Director.

Qualifications Graduate Degree required from an accredited medical school and residency program required.

Master’s degree in healthcare administration, business, or public health preferred.

Possess an unrestricted, current, active license to practice medicine, issued by the NY State Board of Licensure or the State Board of Osteopathic Examiners.

Must be a member in good standing in the medical community.

Board certified in a recognized medical specialty as recognized by the American Board of Medical Specialists (ABMS), preferably in Primary Care (internal medicine, family practice, etc.) preferred.

Five (5) years of post-graduate clinical experience in health care management and utilization review required; quality assurance and peer review experience preferred.