Weekend Associate Medical Director – 0.3 FTE
Job Description:
- Assist the CMO with monitoring availability, appropriateness, and necessity of care rendered by participating providers and out-of-plan providers
- Participate in oversight and clinical decision making of the UM program
- Contribute to development of quality care guidelines, internal peer review procedures and evaluation of medical care evaluation studies
- Provide medical consultation for medical/legal issues, member grievance procedures, and development of new benefit packages
- Promote positive relationship between NHP and medical community
- Serve as spokesperson for NHP in the medical community and maintains appropriate contact with professional health care organizations
- Participate in ongoing recruitment of plan physicians
- Assist in development of appropriate medical guidelines and parameters for claims review
Requirements:
- Doctor of Medicine (MD or DO), licensed in the state of Wisconsin without restriction
- Member in good standing of the local medical community
- An active practitioner of medicine in the NHP service areas
- Thorough knowledge of health professional and facilities and standards of practice of medicine in NHP’s service area
- Sufficient medical experience and knowledge of the Medicare program to review organization determinations involving medical necessity
- Board certified in an ABMS medical specialty
Benefits:
- Opportunity to work hard and have fun while getting paid to volunteer in your local neighborhood
- Reliable internet is required for home office work
- Occasional travel required
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