Job Description

New: Part-Time Medical Director Opportunity in Michigan!!

New: Part-Time Medical Director Opportunity in Michigan!!
Position Available: Medical Director, MD or DO, preferably in a general field of medical practice.
Position Available due to Retirement.
Start Date: As soon as possible.
Practice Setting: This position works at a health plan.
NO Call
Hours: The position is a part-time role and the hours worked are negotiable.
Practice Description: It is a Michigan based nonprofit voluntary employees’ beneficiary association. We provide our members and their families with comprehensive medical and prescription coverage and outstanding personal service. We also offer vision, dental and short-term and long-term disability benefits.
Specific Skills or Certifications Needed: 10+ years of experience as a physician; Board certification; unrestricted license in the state of Michigan; the job description notes other minimum qualifications.
Organization provides insurance and customer service to public employees and their families; a majority of our members work in Michigan public schools. We serve about 66,000 members plus their families (about 180,000 total covered lives).
This position does not have a patient load, per se. The medical director reviews a variety of cases weekly to determine medical necessity. Cases involved relate to preauthorization of medical services, disability case determinations and appeals. The incumbent medical director completes this work in less than 20 hours per week and with support from registered nurses.
Compensation: The position is an independent contractor for which we negotiate an hourly base rate. We reimburse for all reasonable and approved expenses incurred in connection with the performance of approved services based on Organization travel and expense reimbursement policies
Organization shall maintain professional liability insurance with minimum limits of $100,000/$300,000. Organization will pay the premium for this liability insurance.
SERVICE POPULATION: 180,000 members, primarily public employees and their families.
The independent consulting agreement will be reviewed regularly. The medical director shall maintain all licenses necessary to practice medicine in the state of Michigan and such other licenses as may be required to satisfy obligations under a consulting agreement negotiated between the parties. Organization will reimburse for fees associated with maintaining Board Certifications as follows: exam fee (not to exceed $2,000), exam preparation materials (not to exceed $1,000) and exam preparation course fee (not to exceed $2,500).
JOB DESCRIPTION:
The medical director will consult with and advise Organization on providing quality
healthcare and disability coverage to it's members. The medical director will work
with Organization and its underwriters on matters of medical necessity, quality and
reasonableness of medical treatment in concurrent reviews and in appeals decisions.
This position is that of an independent contractor; it involves approximately 20 hours per
week. It is based in Mich., and may be partly remote.
It is a Michigan-based nonprofit voluntary employees’
beneficiary association (VEBA). We provide our members and their families with the
largest provider network in Michigan, comprehensive medical and prescription coverage
and outstanding personal service. We also offer vision, dental and short-term and longterm
disability benefits.
We believe the hardworking people who care for our kids, our schools and our
communities deserve exceptional health benefits and unmatched personal service.
Organization is deeply committed to diversity and inclusion. We are an affirmative action,
equal opportunity employer. People of color, women, and members of other historically
marginalized social identity groups are encouraged to submit a letter of interest.
The medical director:
• Performs physician-level review of medical and disability claims and
preauthorization requests for coverage determinations.
• Determines medical necessity of requests, including appeals, using medical
policy, established guidelines or current research
• Serves as a clinical resource and subject matter expert to both clinical and nonclinical staff
• Recommends clarifications and updates to medical benefits, including assisting in
identifying experimental/investigational treatment(s) and newer technologies,
surgeries and medications
• Participates in quality initiatives, case management accreditation and utilization
management to identify opportunities for improvement
• Participates in pharmacy initiatives and reviews of requested prescription drugs
• Reviews requests for over-age dependents, including appeals
• May be asked to participate in committees and workgroups to achieve department
and organizational objectives
• Various other duties as the need arises
Minimum Qualifications
Current unrestricted state of Michigan Doctor of Medicine (M.D.) or doctor of osteopathy (D.O.) license
Doctorate from an accredited school of medicine (M.D.) or osteopathy (D.O.)
10+ years of experience as a physician, preferably in a general field of medical practice
Board certified
Results-oriented and has the ability to take ownership of work
Strong communication and interpersonal skills
Strong analytical skills
Ability to work both independently and within a team environment
Understanding of health plan functions related to utilization, care and quality management.

Addiction Medicine Jobs Allergy and Immunology Jobs Anesthesiology Jobs Bariatric Surgery Jobs Breast Surgery Jobs Cardiology (Interventional) Jobs Cardiology (Invasive) Jobs Cardiology (Non-Invasive) Jobs Cardiothoracic Surgery Jobs Cardiovascular Surgery Jobs Child/Adolescent Psychiatry Jobs Colon and Rectal Surgery Jobs Critical Care Medicine Jobs CRNA Jobs Dentist Jobs Dermatology Jobs Electrophysiology Jobs Emergency Medicine Jobs Endocrinology Jobs ENT Jobs Facial Plastic Surgery Jobs Family Practice Jobs Foot/Ankle Surgery Jobs FP/OB Jobs Gastroenterology Jobs General Practice Jobs General Surgery Jobs Geriatrics Jobs Gynecology Jobs Gynecology/Oncology Jobs Hand Surgery Jobs Hematology/Oncology Jobs Hospitalist Jobs Infectious Disease Jobs Internal Medicine Jobs Maternal-Fetal Medicine (Perinatology) Jobs Med/Peds (Internal Medicine & Pediatrics) Jobs Medical Director Jobs Neonatology Jobs Nephrology Jobs Neurological Surgery Jobs Neurology Jobs Nurse Practitioner Jobs OB/GYN Jobs Occupational Medicine Jobs Oncology Jobs Ophthalmology Jobs Oral/Max Surgery Jobs Orthopedic Surgery Jobs Pain Medicine Jobs Palliative Care Jobs Pathology Jobs Pediatric Surgery Jobs Pediatrics Jobs Physical Medicine and Rehab Jobs Physician's Assistant Jobs Plastic Surgery Jobs Podiatry Jobs Psychiatry Jobs Pulmonary/Critical Care Jobs Radiation Oncology Jobs Radiology (Interventional) Jobs Radiology Jobs Reproductive Endocrinology Jobs Rheumatology Jobs Sleep Medicine Jobs Spinal Cord Injury Jobs Spine Surgery Jobs Sports Medicine Jobs Surgical Oncology Jobs Thoracic Surgery Jobs Total Joint Surgery Jobs Trauma Surgery Jobs Urgent Care Medicine Jobs Urogynecology Jobs Urology Jobs Vascular Surgery Jobs Wound Care Jobs

State: Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming

Are you sure you want to delete this file?

#J-18808-Ljbffr

Job Tags

Hourly pay, Temporary work, Part time, For contractors, Remote job,

Similar Jobs

ACLU

Deputy Project Director, Disability Rights Program. (Washington) Job at ACLU

...National office in San Francisco, CA, or Washington, D.C. The Disability Rights Project strives for an America free of discrimination against people with disabilities; where people with disabilities are valued, integrated members of society who have full access to...

ZoomEssence, Inc

Food Scientist Job at ZoomEssence, Inc

...quality flavors. We are expanding our Product Development Team in Hebron KY and seeking a hands-on, creative, and meticulous PD Food Scientist to support the development of food-based flavors and finished product concepts. The PD Food Scientist will be responsible...

Adtalem Global Education

Asst Professor- PA Prog (AD1665) Job at Adtalem Global Education

...(BSN) degree program at 23 locations and online post-licensure degree programs and certificates... ...This role offers a unique opportunity to teach in various learning environments while... ...practice credentials, as appropriate, based on assignment. Excellent communication...

YINAN NEW YORK

Fashion Design & Production Internship Job at YINAN NEW YORK

...strength and intimacy. We are inviting NYC-based, on-site fashion interns to join our Manhattan atelier in shaping a collection defined... ...Youll Gain: Immersive, hands-on experience in couture-level dressmaking Insight into collection development and design studio...

Haley & Aldrich

Project Environmental Engineer or Geologist Job at Haley & Aldrich

...procedures appropriate for their discipline. Compile, reduce, analyze, manage, and report field, instrumentation, geological, and/or environmental data using spreadsheets and other tools. Prepare written reports, proposals, cost estimates, and other client deliverables...

New: Part-Time Medical Director Opportunity in Michigan! Job at Doctor's Choice Placement Services, Inc, Lansing, MI

bjl2S2QxQ3V2TWZPZGthU0Npc3k3SzJr