Associate Medical Director jobs in Cincinnati, OH

Associate Medical Director supports the implementation of medical policies for the entire organization. Ensures the delivery of quality patient care. Being an Associate Medical Director researches and evaluates new treatments and medical innovations. Works collaboratively throughout the organization to ensure the adoption of standards and policies for all functional aspects of clinical services that result in patient care improvements. Additionally, Associate Medical Director requires a MD degree. Typically reports to Medical Director. The Associate Medical Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. To be an Associate Medical Director typically requires 5+ years of managerial experience. (Copyright 2024 Salary.com)

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Associate Medical Director
  • CommuniCare Advantage
  • Cincinnati, OH FULL_TIME
  • Associate Medical Director

    The CommuniCare Family of Companies currently owns/operates more than 85 Nursing and Rehabilitation Centers, Specialty Care Centers and Assisted Living Communities in 7 states. Since 1984, CommuniCare Health Services has provided superior, comprehensive management services for the development and management of adult living communities.
    Due to growth, we are seeking an experienced Associate Medical Director.

    The position of part-time Associate Medical Director is responsible for supporting the Medicare Advantage Plans clinical and quality activities and operations at the direction of the Chief Medical Officer approximately 25 hours per week. This position reports directly to the Chief Medical Officer, Medicare Advantage Plans.
    Job duties & responsibilities may include the following and will be finalized based on the skills and interests of the successful candidate:
    • Medical Management
    • Support strategies and interventions to improve quality outcomes, medical expense trends, and STARS ratings
    • Health Care Services Management
    • Conduct prior authorization and utilization management activities including adverse determinations.
    • Collaborate with consultant physicians as necessary to review selected authorization requests or appeals of adverse determinations.
    • Support processes relating to performance and audit of vendors or provider organizations delegated for UM.
    • Lead review and submission of clinical practice guidelines, utilization and concurrent review criteria, and other similar guidelines to Medical Policy or applicable committees.
    • Participate in Plan committees such as Medical Policy, Credentialing, Quality Improvement, Peer Review and others as assigned.
    • Collaborate with medical directors and other clinical leaders from across the contracted network including CHS affiliates as on assigned projects .
    • Support care innovations across the enterprise
    Support the implementation and execution of the Quality Assurance Plan including but not limited to:
    • Models of Care
    • STARS and clinical quality
    • Member and provider satisfaction
    • Provider network accessibility, availability and qualifications]
    • Grievance and Appeals
    • Support the development and implementation of the Models of Care across the health plan, the CHS Family of Companies and network of providers.
    • Plan Pharmacy Operations
    • Participate in various pharmacy related meetings or activities as assigned.
    • Support processes related to pharmacy appeals process including appeals of adverse determinations.
    • Regulatory and Compliance
    • Assure consistent, high quality execution on HIPAA, Privacy, Program Integrity and Fraud, Waste and Abuse protections and activities
    • Complete annual Plan compliance training, IRR, and other compliance-related activities.
    • Assure adherence to documentation and requirements as set forth in the Model of Care for each MA SNP plan
    • Assure adherence to regulatory requirements regarding Quality Committees including Quality Improvement, Credentialing, Medical Policy, Peer Review, Quality of Care committees and related activities
    • Growth and Census Support
    • Physician Recruitment: Medical Directors, Specialty Physician Program Directors, Attending Physicians
    • Attain and enhance physician and hospital relationships to increase referrals
    • Participate in data reviews, sharing and initiatives to improve member outcomes
    • Liaison to providers when necessary to solicit participation in the Plan provider network, committees or to address QOC or other issues.
    • Serve as ambassador to other enterpriseMedical Directors and clinical leaders
    Qualifications & Experience requirements
    • Requires a degree in medicine from an accredited school, Board Certification, and is licensed to practice in applicable states in which the Plan operates.
    • Requires at least 15 years of Clinical Experience.
    • Requires 3 to 5 years prior experience as a CMO or Associate Medical Director preferably for a Medicare, MMP, or Medicaid plan inclusive of dually eligible enrollees.
    • Experience in working in post-acute facilities, assisted living facilities, home and community-based service settings preferred.
    • Geriatric training and experience preferred but not required.
  • 22 Days Ago

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Associate Medical Director
  • CommuniCare Advantage
  • Cincinnati, OH FULL_TIME
  • Associate Medical Director The CommuniCare Family of Companies currently owns/operates more than 85 Nursing and Rehabilitation Centers, Specialty Care Centers and Assisted Living Communities in 7 stat...
  • Just Posted

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Associate Medical Director
  • Western & Southern Financial Group
  • CINCINNATI, OH FULL_TIME
  • Overview Summary of Responsibilities: Performs medical underwriting/medical risk analysis, establishes underwriting standards, and reads EKG's for Western & Southern and Columbus Life New Business. Ac...
  • 28 Days Ago

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Associate Medical Director
  • CommuniCare Family of Companies
  • Cincinnati, OH FULL_TIME
  • Associate Medical Director The CommuniCare Family of Companies currently owns/operates more than 85 Nursing and Rehabilitation Centers, Specialty Care Centers and Assisted Living Communities in 7 stat...
  • 1 Month Ago

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Medical Director
  • Theoria Medical
  • Cincinnati, OH FULL_TIME
  • Position Type: Part-time, exempt Compensation: Up to $400,000 annually monthly Medical Director Stipend Job Highlights Work-Life Balance: Competitive compensation with balanced hours. Weekend & On-Cal...
  • 25 Days Ago

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Medical Assistant w/ Degree for Associate Director
  • Ross Education Holdings Inc
  • Cincinnati, OH FULL_TIME
  • ASSOCIATE DIRECTOR – FULL TIME – MONDAY - FRIDAY Are you an experienced Medical Assistant who is ready for that next step in your career? Ready to help students achieve their goals? The Associate Dire...
  • 1 Month Ago

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0 Associate Medical Director jobs found in Cincinnati, OH area

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Mental Health Technician (MHT), 7pm- 7am
  • Blueridge Vista Behavioral Hospital
  • Cincinnati, OH
  • New Vista Health and Wellness is currently recruiting for Mental Health Technicians (MHT) at Blue Ridge Vista. Night Shi...
  • 4/26/2024 12:00:00 AM

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Psychiatrist - Medical Director
  • Medpace
  • Cincinnati, OH
  • Job Summary We are seeking a Psychiatrist - Medical Director to join our dynamic team. The Medical Director will have ov...
  • 4/25/2024 12:00:00 AM

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Executive Director LNHA (Licensed Nursing Home Administrator)
  • Scarlet Oaks Retirement and Rehabilitation Center
  • Cincinnati, OH
  • Scarlet Oaks Retirement and Rehabilitation Center - Join Scarlet Oaks Community in Cincinnati, Ohio as a dedicated Nursi...
  • 4/24/2024 12:00:00 AM

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Immunologist- Medical Director
  • Medpace
  • Cincinnati, OH
  • Job SummaryWe are seeking an Immunologist- Medical Director to join our dynamic team. The Medical Director will have ove...
  • 4/24/2024 12:00:00 AM

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Caregiver
  • HCAOA
  • Ft Mitchell, KY
  • BrightStar Care of Northern Kentucky is looking for Caregivers to join our team serving clients living in Florence, Walt...
  • 4/24/2024 12:00:00 AM

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Licensed Therapist
  • Pinnacle Treatment Centers
  • Covington, KY
  • Overview: We offer competitive salaries, full benefits package, Paid Time Off, and opportunities for professional growth...
  • 4/23/2024 12:00:00 AM

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Assistant Care Coordinator
  • the trak group
  • Cincinnati, OH
  • Job Description Job Description Assistant Care Coordinator How would you enjoy working for a stable company that offers ...
  • 4/22/2024 12:00:00 AM

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Physician, Supplemental, Emergency Medicine
  • Cincinnati Children's Hospital Medical Center
  • Cincinnati, OH
  • Expected Starting Salary Range: - SUPERVISOR'S TITLE: Assistant Professor; Associate Professor; Professor; Clinical Dire...
  • 4/22/2024 12:00:00 AM

Cincinnati (/ˌsɪnsɪˈnæti/ SIN-sih-NAT-ee) is a major city in the U.S. state of Ohio, and is the government seat of Hamilton County. Settled in 1788, the city is located at the northern side of the confluence of the Licking and Ohio rivers, the latter of which marks the state line with Kentucky. The city drives the Cincinnati–Middletown–Wilmington combined statistical area, which had a population of 2,172,191 in the 2010 census making it Ohio's largest metropolitan area. With a population of 296,943, Cincinnati is the third-largest city in Ohio and 65th in the United States. Its metropolitan ar...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Associate Medical Director jobs
$290,715 to $385,010
Cincinnati, Ohio area prices
were up 1.1% from a year ago

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