What are the responsibilities and job description for the Health Services Clinical Lead position at Sunshine State Health Plan?
Sunshine State Health Plan is a leading health insurance company that serves millions of members across the country. As a Behavioral Medical Director, you will be part of our team that is dedicated to improving the quality and cost-effectiveness of healthcare services.
This role requires a medical professional with a strong background in utilization management, cost containment, and medical quality improvement activities. You will be responsible for directing and coordinating the medical management, quality improvement, and credentialing functions for our business unit.
The ideal candidate will have excellent communication and leadership skills. They should be able to interface with physicians and other providers to facilitate implementation of recommendations to improve utilization and healthcare quality.
You will also be responsible for identifying utilization review studies and evaluating adverse trends in utilization of medical services. This involves collaborating with care management teams to optimize outcomes for high-risk patients.
We are looking for a medical expert who can develop alliances with the provider community through the development and implementation of medical management programs.
This is a challenging yet rewarding role that requires a strong commitment to excellence. As a Behavioral Medical Director, you will have the opportunity to make a meaningful impact on the lives of our members.
