Medical Director - PRN

National Healthcare company is hiring for a Medical Director to work as needed!

!00% Remote

Must have a Massachusetts Physician License

This Role is for coverage in case of PTO, medical leave, unforeseen circumstances.

Responsibilities for a Medical Director include:

-Performs daily review of home and community-based services to approve or deny appropriate services for members. Will work with nursing staff to clarify requests and documentation as needed

-Represents the health plan in Board of Hearing cases

-Responsible for appropriate utilization management including managing/monitoring the results of Care Management/ Health services interventions to ensure that utilization goals are achieved; collaborating with Care Management/ health services/behavioral health as necessary to maintain focus on achieving targets.

-Works toward fully integrated clinical model working with Behavioral Health and clinical management

-Supports all clinical quality initiatives and peer review processes

-Collaborates with the health plan Chief Medical Officer, and other clinical staff as a clinical resource and coach to support programs and health plan goals

- Collaborates with the Chief Medical Officer, clinical operations staff, and other market staff to support and meet market and national clinical operations goals.

-Accountable for providing clinical leadership primarily focusing on home and community-based services review and external communication with network physicians

-May assist in the development and implementation of local plan clinical policies and procedures, quality improvement activities and performance improvement projects

Qualifications:

- Active/unrestricted Licensed physician in Massachusetts

- Board Certified in an ABMS or AOBMS specialty

- 5+ years clinical practice experience; strong knowledge of managed care industry and the Medicaid line of business.

- 2 - 3 years Quality management experience

- Familiarity with current medical issues and practices

Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact [email protected].


Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).


This posting is open for thirty (30) days.

It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.