Medical Director - Radiology - Part Time
What you will be doing:
The Medical Director is responsible for processing UM requests that do not meet guidelines, processing appeals, education of the ordering providers in peer-to-peer calls.• The Medical Director is also responsible for review of criteria yearly.• NY, NM and/or CA medical license is required• Must be a Board-Certified Radiologist
Key Responsibilities
Responsible for processing UM requests, appeals, and reconsiderations. Required to write a denial rationale in compliance with health plan and government agencies.
Required to be compliant with contractual obligations to the health plans and government agencies, and certifications that are maintained by Care to Care.
Required to participate in quarterly UM meetings
Responsible for identifying educational needs and participating in ongoing education and support for the medical and intake staff.
Responsible for acting as a clinical liaison to providers, clients, and patients as directed by the Chief Medical Officer
Responsible for communicating need for additional clinical information to referring/prescribing providers related to consideration for authorization or modification of a referring provider’s request for radiological or diagnostic imaging services.
Required to collaborate with management to create and implement new process or quality improvement initiatives
Responsible for coordinating with UM Intake Specialists to ensure timely and accurate communication of clinical decisions
Required to collaborate with clinical team to review and update clinical criteria guidelines at least annually.
Required Certifications/Licensing
Current, unrestricted medical license in required specialty (NY, NM or CA license required)
Board certified in Radiology required
Required Qualifications
Work Experience:Years of Applicable Experience - 7 or more yearsEducation:MD: Medicine (Required)
Preferred Qualifications
Skills:
Strong clinical, management and organizational skills.
Excellent verbal and written communications skills
Proficient computer skills
High degree of personal integrity and ethical conduct
Self-motivated and directed.
Works well with others
Experience:
Current, unrestricted medical license in required specialty (NY, NM or CA license required)
Board certified in required specialty (Radiology specialty required)
Knowledge of regulatory requirements
Additional Job Requirements:
Remain in a stationary position for prolonged periods of time
Be adaptive and change priorities quickly; meet deadlines
Attention to detail
Operate computer programs and software
Ability to communicate effectively with audiences in person and in electronic formats.
Day-to-day contact with others (co-workers and/or the public)
Making independent decisions
Ability to work in a collaborative business environment in close quarters with peers and varying interruptions
Working Conditions: RemoteTravel Requirements: No travel requiredPhysical Demands: Sedentary: Exerting up to 10 pounds of force occasionally, and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves remaining stationary most of the time. Jobs are sedentary if movement is required only occasionally, and all other sedentary criteria are met.Premier’s compensation philosophy is to ensure that compensation is reasonable, equitable, and competitive in order to attract and retain talented and highly skilled employees.
Premier’s internal salary range for this role is $155,000 - $289,000. Final salary is dependent upon several market factors including, but not limited to, departmental budgets, internal equity, education, unique skills/experience, and geographic location. Premier utilizes a wide-range salary structure to allow base salary flexibility within our ranges.Employees also receive access to the following benefits:·Health, dental, vision, life and disability insurance·401k retirement program·Paid time off·Participation in Premier’s employee incentive plans·Tuition reimbursement and professional development opportunities
Premier at a glance:
- Ranked #1 on Charlotte’s Healthiest Employers list for 2019, 2020 and 2022, and 49th Healthiest Employer in America (2022)
- Named one of the World’s Most Ethical Companies® by Ethisphere® Institute for the 13th year in a row
- The only company to be recognized by KLAS twice for Overall Healthcare Management Consulting
Employees receive:
- Perks and discounts
- Access to on-site and online exercise classes
- Paid time off to volunteer in their communities
Premier is looking for smart, agile individuals like you to help us transform the healthcare industry. Here you will find critical thinkers who have the freedom to make an impact. Colleagues who share your thirst to learn more and do things better. Teammates committed to improving the health of a nation. See why incredible challenges require incredible people.Premier is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to unlawful discrimination because of their age, race, color, religion, national origin, ancestry, citizenship status, sex, sexual orientation, gender identity, gender expression, marital status, familial status, pregnancy status, genetic information, status as a victim of domestic violence, covered military or protected veteran status (e.g., status as a Vietnam Era veteran, disabled veteran, special disabled veteran, Armed Forces Serviced Medal veteran, recently separated veteran, or other protected veteran) disability, or any other applicable federal, state or local protected class, trait or status or that of persons with whom an applicant associates.
We also consider qualified applicants with criminal histories, consistent with applicable federal, state and local law. In addition, as a federal contractor, Premier complies with government regulations, including affirmative action responsibilities, where they apply.Premier also provides reasonable accommodations to qualified individuals with a disability or those who have a sincerely held religious belief. If you need assistance in the application process, please reply todiversity_and_accommodations@premierinc.comor contact Premier Recruiting at 704.816.5200.Information collected and processed as part of any job application you choose to submit to Premier is subject to Premier’sPrivacy Policy.
