Medicare Medical Director
Core
Lead clinical, quality, care management, and population health strategies for a Medicare Advantage population to improve outcomes and reduce costs.
Role type
Senior Medical Director (Medicare Advantage)
Builds
Population health programs and clinical quality initiatives for Medicare members
Domain
Healthcare / Medicare Advantage / Population Health
Required skills
Clinical medicine (MD/DO), Board certification, State medical license, Direct patient care, Managed care, Quality improvement, Cost containment, Provider engagement, Strategic planning
Preferred skills
Utilization review, Case management, Clinical documentation improvement (Risk Adjustment), Stakeholder buy-in, Residency in adult primary care/geriatrics
Technologies
None stated
Responsibilities
Oversee clinical and quality outcomes for Medicare population; Identify opportunities for program enhancements; Lead clinical engagement with physicians; Improve clinical documentation and risk adjustment; Develop best practices with providers; Collaborate on quality initiatives; Act as liaison to network providers; Provide alternative approaches for practice performance; Maintain strategic stakeholder relationships
Seniority
Senior, hands-on IC with leadership responsibilities