Medical Director UM

EMPOWER HEALTHCARE SOLUTIONS • Little Rock, AR

9d • $1 - $1

About The Position

Empower, a Provider-Led Arkansas Shared Savings Entity (PASSE) serving Medicaid clients with complex behavioral health, developmental, or intellectual disabilities, is seeking a Medical Director- Utilization Management. The medical director will play a pivotal role in the clinical leadership and development of population health programs and functional areas within Medical Management. You will be responsible for reviewing cases that do not meet established evidence-based clinical criteria or when criteria or client policies do not exist for the requested service(s). Reporting directly to the Associate Vice President of Clinical Strategy and Care Integration, the Medical Director is tasked with making critical clinical review determinations and providing guidance across various medical management initiatives, such as high-risk care management, population management, and health and wellness programs.

Requirements

• Graduate of an accredited medical school with an M.D. degree.
• Active, unrestricted physician license.
• 3-5 years of clinical practice experience, with progressively responsible administrative experience in a medical management setting.
• Strong clinical knowledge and decision-making skills in various specialties.
• Exceptional communication skills and the ability to collaborate effectively with diverse healthcare teams.
• Strong organizational, analytical, and problem-solving abilities.
• Ability to navigate complex clinical and operational challenges in a fast-paced healthcare environment

Nice To Haves

• Experience in medical administration and clinical leadership is preferred.
• Master’s in Business Administration (MBA) or a related master’s degree in healthcare or a similar field is preferred.

Responsibilities

• Reviewing cases that do not meet established evidence-based clinical criteria or when criteria or client policies do not exist for the requested service(s).
• Making critical clinical review determinations
• Providing guidance across various medical management initiatives, such as high-risk care management, population management, and health and wellness programs.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Education Level: Ph.D. or professional degree