Medical Director jobs in Somerset, NJ
Medical Director plans and directs all aspects of an organization's medical policies, standards, and programs. Responsible for strategic clinical relationships with physicians and interns. Being a Medical Director ensures all clinical programs are in compliance with all applicable regulations. Researches and studies current medical publications and data on new treatments and practices to ensure high quality clinical service offerings. Additionally, Medical Director advises non medical management on clinical and patient related matters and policies. Requires a MD degree. Typically reports to top management. The Medical Director manages a departmental function within a broader corporate function. Develops major goals to support broad functional objectives. Approves policies developed within various sub-functions and departments. To be a Medical Director typically requires 8+ years of managerial experience. Comprehensive knowledge of the overall departmental function. (Copyright 2024 Salary.com)
Recently Added Medical Director jobs
Medical Director
- 100 Horizon Healthcare Services, Inc
-
Hopewell, NJ
FULL_TIME
- Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware Job Summary: The Medical Director is a medical spokesperson for Horizon Blue Cross Blue Shield with the provider network across NJ. The Medical Director will be accountable for providing leadership, direction and daily support for their assigned region of NJ and assigned providers; the scope of activities include, but are not limited to, utilization management, care management, disease management, quality management, pharmacy management, post service reviews, provider education, support for provider relations issues, and clinical transformation. The Medical Director is accountable for a personal caseload of daily medical management activities and contributing to operational effectiveness of the medical management program. Medical Policy and HPIRIT only: The position has primary responsibility for the medical review for the Clinical Inquiries Team (CIT) and support special investigations unit as needed. Also, the position supports the development and implementation of reimbursement policies. Responsibilities: Support all lines of business which includes Commercial and Government Programs. Collaborate with value based teams, Behavioral Health and Pharmacy; supports accounts and activities for cross functional areas by region, where applicable. Supports sales teams as assigned by region. Guides, supports and consults with nurse reviewers on pre-authorization, concurrent and retrospective review issues, post-service reviews, pre-determinations and decisions, where applicable. Consult with/support case management to determine best course for members, assist with PG and address issues. Develops and maintains effective collaborative relationships with providers in assigned geographic areas. This includes on site or virtual review of performance and coaching activities with physicians, hospitals and ancillary providers. May provide input into provider credentialing, profiling and communication initiatives. Responsible for data analysis on case management and utilization, identify issues and escalate as necessary to senior management. Interprets and analyzes available utilization, cost and quality reports and develops steps to address variances to target performance matrix. Collaborates on documentation of monthly reporting address performance, issues and activities for assigned region. Assists with assessment of network capabilities by region and collaborates with network management, contracting and value based teams in addressing network gaps. Creates/participates in internal or external educational activities for other members of the team/stakeholders across regional/functional areas. Participates in Committee activities as assigned. Assist with coverage across functional MD teams, as needed, including participation in calls for all areas. Support medical policy development process, review medical and pharmacy policies and provide feedback regarding utilization to the development team. Works with legal and mandate team to support Horizon’s compliance with the NJ Department of banking and insurance (DOBI). Backup chair for committees with internal and external stakeholders Medical Policy and HPIRIT only: Performs medical reviews for the Clinical Inquiries Team (CIT) and support special investigations unit as needed Support development and implementation of reimbursement policies Assist with coverage across functional MD teams as needed including participation in calls for all areas Functional Competencies: Knowledge in the principles of Utilization Management, Case Management, Quality Management and accreditation/regulatory standards. Requires broad clinical knowledge and understanding of current health care issues and climate. Requires some knowledge of health insurance payer business including business operations. Qualifications: Requires Board Certification in an American Board of Medicine recognized specialty. Requires current unrestricted MD or DO license to practice medicine. Requires 5-7 years Clinical Experience with managing data to identify key issues, developing recommendations and providing content/conclusions to executive management. Proficiency working with Tableau or similar software required. Proficiency also required working with a Windows based environment including MS Office products. Continuous Improvement Experience Preferred. Specific to Medical Policy: Ability to review studies, understand evidence based medicine and support medical policy development. Ability to chair committees with internal and external stakeholders. Additional licensing, certifications, registrations: Active Unrestricted MD or DO License Required; NJ License Required, No CMS Sanctions or sanctions by other regulatory agencies or boards. Must be board certified by a specialty recognized by the American Osteopathic Association or the American Board of Medical Specialties. Knowledge, Skills and Abilities: Business Acumen: Identify key issues and opportunities, developing strategies and plans and have resolute decision making. Planning and Organizing: Leveraging resources, staying focused and effectively prioritizing key objectives. Building Strategic Working Relationships: Proactively tries to build effective working relationships; facilitates agreement; clarifies current situation; involving appropriate individuals within team and broader organization to achieve desired results Executive Presence: Advocates for the organization, inspiring confidence among peers regarding reliability and capability, inspiring senior leadership expectations on potential for outstanding outcomes and achievements. Meeting Leadership: Ensures a meeting serves its business objectives; facilitating agreement; develops others' and own ideas; closes discussions with clear summaries. Negotiation: Effectively exploring alternatives and positions to reach outcomes that gain the support and acceptance of all parties. Matrix Environment: Ability to function and work in a matrix environment which includes working on and at time leading cross functional teams. Conflict resolution: ability to identify conflict, determine its causes and negotiate mutually agreeable solutions. Travel % (If Applicable): The position requires access to a car and the ability to travel for meetings with physicians, hospitals and ancillary providers as required. Salary Range: $207,800 - $289,170 This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. This range has been created in good faith based on information known to Horizon at the time of posting. Compensation decisions are dependent on the circumstances of each case. Horizon also provides a comprehensive compensation and benefits package which includes: Comprehensive health benefits (Medical/Dental/Vision) Retirement Plans Generous PTO Incentive Plans Wellness Programs Paid Volunteer Time Off Tuition Reimbursement Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law. Horizon will consider reasonable accommodation requests as part of the recruiting and hiring process. About Us We are the leading health insurer in New Jersey, trusted by generations of families and businesses. We are dedicated to enriching the lives and health of our members and the New Jersey communities we serve, because we live and work here too. Our Mission We empower our members to achieve their best health. Our Vision We are New Jersey’s health solutions leader driving innovations that improve health care quality, affordability and member experience in the markets we serve.
- 14 Days Ago
#13451 - Technology Sales Director (Retail & Consumer Goods)
- Technology Sales Director (Retail & Consumer Goods) - Qualitest
-
Bridgewater, NJ
FULL_TIME
- Are you interested in working with the largest independent software testing company? Read on!Qualitest is looking for an experienced Regional Sales Director to develop new logo sales for Retail and Co...
- 12 Days Ago
Director of Nursing
- American Medical Associates
-
Raritan, NJ
FULL_TIME
- Director of Nursing- LTC *Salary: $115K-$145K per year (depending on experience)* Requirements of the Director of Nursing: Must have prior experience as an Assistant Director of Nursing or Director of...
- 1 Month Ago
Director Medical Analytics
- Regeneron Pharmaceuticals Inc.
-
Basking Ridge, NJ
FULL_TIME
- The Director of Statistical Programming Medical Affairs provides leadership to the group in Medical Affairs, including Health Economics and Outcomes Research (HEOR). The incumbent is responsible for a...
- 20 Days Ago
Senior Medical Director Oncology
- Precision for Medicine
-
Gladstone, NJ
FULL_TIME
- Precision for Medicine is the first global precision medicine clinical research services organization, purpose-built to improve the clinical research and development process for new therapeutics. Our ...
- 4 Days Ago
Senior Medical Director Oncology
- Precision Medicine Group
-
Gladstone, NJ
FULL_TIME
- Precision for Medicine is the first global precision medicine clinical research services organization, purpose-built to improve the clinical research and development process for new therapeutics. Our ...
- 4 Days Ago
Filters
- Current Active Filter
- Somerset, NJ
Clear All
- Filter Jobs By posted time
- Within 1 Day
- Within 2-7
- Within 1 Month
- Within 3 Months
0 Medical Director jobs found in Somerset, NJ area
Medical Director
- Envision Healthcare
-
North Bergen, NJ
- Job Details Envision Physician Service is seeking a Hospitalist Site Medical Director for Hackensack Meridian Health Pal...
- 4/26/2024 12:00:00 AM
Medical Director
- Veterinary Practice Partners
-
Bogota, NJ
- Seeking an independent, compassionate Veterinarian/Medical Director to join our team! Why Overpeck Creek Animal Hospital...
- 4/26/2024 12:00:00 AM
Veterinarian - Medical Director
- Innovetive Petcare
-
Long Island City, NY
- Veterinarian - Medical Director Department: Veterinarians Employment Type: Full Time Location: Long Island City, New Yor...
- 4/26/2024 12:00:00 AM
Associate Medical Director
- Services For The Underserved, Inc.
-
Brooklyn, NY
- Min: USD $235,000.00/Yr. Max: USD $240,000.00/Yr. Position Overview: Location: C Train Brooklyn, New York 11238 Salary: ...
- 4/26/2024 12:00:00 AM
Site Medical Director
- Adecco Staffing, USA
-
New York, NY
- Our organization is seeking a site medical director or senior psychiatrist to assist patients in a unique setting. More ...
- 4/26/2024 12:00:00 AM
Medical Director for Medical Clinic
- Engle Recruiting
-
New York, NY
- Job Description Job Description We are a new medical clinic. In addition to comprehensive and complete primary care, we ...
- 4/25/2024 12:00:00 AM
Physician Clinic Medical Director
- Concentra
-
Trenton, NJ
- Concentra Physician Clinic Medical Director Somerset , New Jersey Apply Now Are you ready to take your career to new hei...
- 4/23/2024 12:00:00 AM
Clinical Development Medical Director
- Novartis
-
East Hanover, NJ
- Clinical Development Medical DirectorJob ID394015BRMar 11, 2024USAAbout the RoleOver 108,000. Thats how many US patients...
- 4/23/2024 12:00:00 AM
About Somerset, New Jersey
Somerset is an unincorporated community and census-designated place (CDP) located within Franklin Township, in Somerset County, New Jersey, United States. As of the 2010 United States Census, the CDP's population was 22,083.
Somerset housed one of the first Marconi Wireless Stations in the United States.
According to the United States Census Bureau, the CDP had a total area of 6.444 square miles (16.692 km2), including 6.327 square miles (16.388 km2) of land and 0.117 square miles (0.304 km2) of water (1.82%)....
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Director jobs
$379,178 to $491,639
Somerset, New Jersey area prices
were up 1.5% from a year ago
were up 1.5% from a year ago
What does a Medical Director do?
Medical Director in Alexandria, LA
Wolk, M.D., one of the medical directors with whom Brooks works closely.
November 26, 2019
Medical Director in Lima, OH
First and foremost, hospice medical directors are committed to ensuring that every patient is provided with the highest level of care and that the care provided meets every patient’s unique needs.
November 20, 2019
Medical Director in Youngstown, OH
Guidelines for providing information to qualifying patients related to risks, benefits, and sides effects associated with medical marijuana.
October 16, 2019