Medical Director

Join our EPIC team at Wexford Senior Care Center!

The Medical Director is responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and implementation of policies and procedures that guide and support the provisions of medical staff services. Maintains a working knowledge of applicable national, state, and local laws and regulatory requirements affecting the medical and clinical staff.

You Will Earn

• Competitive Wages
• Yearly Wage Increases
  
  

PLUS We Offer You Best In Class Benefits

• Medical – no deductible or co-pay
• Dental & Vision
• Generous Paid Time Off PTO
• Holiday Pay
• Career Advancement Opportunities – grow your nursing career!
• Tuition Discounts - Hondros College of Nursing
• Tuition Reimbursemen
• RN Loan Repayment
• Company paid Short Term Disability & Life Insurance
• Unlimited Referral Bonuses - Build your own team of Heroes!
• 401k with employer match
• Attentive & Supportive Leadership!
  
  

We Can Work With Your Scheduling Needs

• Full Time
  
  

How You Will Help People Every Day

• Provide medical oversight and expertise in appropriateness and medical necessity of healthcare services provided to members, targeting improvements in efficiency and satisfaction for patients and providers, as well as meeting or exceeding productivity standards.
• Educate and interact with network and group providers and medical managers regarding utilization practices, guideline usage, pharmacy utilization and effective resource management.
• Develop and implement a Utilization Management program and action plan, which includes strategies that ensure a high quality of patient care, ensuring that patients receive the most appropriate care at the most effective setting.
• Participate in and maintain the integrity of the appeals process, both internally and externally.
• Review quality referred issues, focused reviews and recommends corrective actions
• Ensure that medical decisions are rendered by qualified medical personnel, not influenced by fiscal or administrative management considerations, and that the care provided meets the standards for acceptable medical care.
• Ensure that medical protocols and rules of conduct for plan medical personnel are followed.
• Provide implementation support for Quality Improvement activities.
  
  

What you will need to be part of our EPIC team:

• Doctorate Degree in Medicine
• Board Certified or eligible in a primary care specialty
• Current State of Michigan Medical license without restrictions to practice and free of sanctions from Medicaid or Medicare.
• 3 years relevant experience, including 2 years previous experience as a Medical Director in a clinical practice.
• Current clinical knowledge; Knowledge of applicable state, federal and third party regulations
• Experience demonstrating strong management and communication skills, consensus building and collaborative ability, and financial acumen.
• Preferred experience with: Peer Review, medical policy/procedure development, provider contracting experience, Medicaid, Medicare and Pharmacy benefit management, Group/IPA practice, capitation, HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment, disease management, and evidence-based guidelines.
• Excellent customer service skills with a commitment to delivering Excellent, Passionate, Innovative care!
• You are a team player, dedicated to doing what it takes to support your team members and get the job done.
  
  

NX1

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This is a full time position

Certifications Required: CPR-BLS Certification

Licensure Required: Medical Doctor