Medical Director

83401 Idaho Falls, Idaho Grifols Shared Services North America, Inc

Posted 1 day ago

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Job Description

Would you like to join an international team working to improve the future of healthcare? Do you want to enhance the lives of millions of people? Grifols is a global healthcare company that since 1909 has been working to improve the health and well-being of people around the world. We are leaders in plasma-derived medicines and transfusion medicine and develop, produce and market innovative medicines, solutions and services in more than 110 countries and regions. **Position Overview:** The Medical Director will be responsible for clinical strategy relating to upcoming clinical trials, including indication selection, design of trials, and ongoing medical monitoring of safety signals in trials. This is a remote role and candidate can be located anywhere within the US. **Responsibilities include, but are not limited to the following:** + Design of trials, including study population and eligibility criteria, treatment duration, clinical endpoints, biomarkers, and safety mitigation strategy + Serve as the Program Physician for associated clinical trials, addressing patient eligibility and treatment questions in collaboration with the contract research organization (CRO) medical monitor, or directly with study investigators + Work closely with preclinical scientists to understand how the biological effects observed in animals can be translated to humans, and use this information to choose the best clinical endpoints and biomarkers for clinical trials + Be familiar with the nonclinical safety data (toxicology) and use this information to develop safety mitigation strategies in clinical trial design + Serve as a key part of the cross-functional project team, supporting the overall strategy, budget, and timeline of the project + Review safety data for individual subjects and trend review for safety signals from ongoing trials + Interpret, summarize, and present data from clinical trials to the company and externally + Provide strategic input for clinical development plans and regulatory strategy + Provide input/review of clinical documents, e.g. protocols, investigator's brochures, case report forms + Participate in site/investigator identification and evaluation for clinical trials; conduct site engagement calls and visits + Lead preparation of clinical sections of relevant regulatory filings (IND, study reports, NDA, etc.) in cooperation with colleagues in Regulatory Affairs and other functions + Serve as program medical expert for internal and external collaborators, investigators, consultants, and contract resources + Provide and enhance knowledge in the associated therapeutic area to support global clinical development plans + Represent the company at scientific meetings and presentations + Attend and provide medical support for investigator and consultant meetings and clinical advisory boards + Develop and manage relationships with key opinion leaders to obtain advice and feedback **Skills/Qualifications/Education Requirements:** (To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, education, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions) + Medical Degree + Typically requires 8 years of clinical research experience with at least 5 years of clinical document production and/or clinical trial feasibility and strategy or related experience. Additional experience may include other pharmaceutical or academic research in the field. + Hands-on experience with clinical trial design, trial conduct and oversight, including medical monitoring for trials in a broad spectrum of indications including medical immunology, hematology, and oncology. + Knowledgeable in GCP guidelines in US and Europe + Team player with good oral presentation and written skills + Collaborative and flexible in personal interactions + Ability to work proactively and effectively, with exceptional problem-solving skills + Up to 25% travel _*Depending on the area of assignment, directly related experience or a combination of directly related education and experience and/or competencies may be considered in place of the stated requirements. Example: If a job level requires a Bachelor's degree plus 4 years of experience, an equivalency could include 8 years of experience, an Associate's degree with 6 years of experience, or a Master's degree with 2 years of experience._ If you have the work ethic and mental agility to embrace a fast-paced and rapidly evolving environment, you will be rewarded with diverse and exciting experiences. This is your chance to add real value to an entrepreneurial organization that supports bold innovation and new ideas. Grifols welcomes passionate, team-oriented colleagues who are looking to improve the health of patients worldwide by developing a deeper understanding of human disease. **Pay Scale:** The estimated pay scale for the Medical Director (1-2) role based in the United States (non-California), is $170,000.00 - $40,000.00 per year/per hour. Additionally, the position is eligible to participate in 15% - 30% of the company bonus pool (depending on level of role). We offer a wide variety of benefits including, but not limited to: Medical, Dental, Vision, PTO, 9 paid Holidays per year, up to 5% 401(K) match and tuition reimbursement. Final compensation packages will ultimately depend on education, experience, skillset, knowledge, where the role is performed, internal equity and market data. We are committed to offering our employees opportunities for professional growth and career progression. Grifols is a global healthcare organization with employees in 30 countries focused on patient health and providing impactful results. Since our humble beginnings in 1909, Grifols has been a family company that prides itself on its family-like culture. Our company has more than tripled over the last 10 years, and you can grow with us! **For Washington State:** Currently, the first year PTO accrual for this role is 160 hours per year. Then, after completion of 365 days of employment the PTO accrual for this role will increase to 180 hours per year. **For California:** The estimated pay scale for the Medical Director (1-2) role based in California, is 170,000.00- 250,000.00 per year. Work is performed in an office environment with exposure to electrical office equipment. Frequently sits for 6-8 hours per day. Repetitive hand movement of both hands with the ability to make fast, simple, repeated movements of the fingers, hands, and wrists. Occasionally walks and stands. Occasionally bends and twists neck. Light to moderate lifting and carrying objects with a maximum lift of 25lbs. Frequently drives to site locations with occasional travel within the United States. Able to communicate information and ideas so others will understand; with the ability to listen to and understand information and ideas presented through spoken and written words and sentences. Interacts with others, relates sensitive information to diverse groups. Must work with diverse groups to obtain consensus on issues. Third Party Agency and Recruiter Notice: Agencies that present a candidate to Grifols must have an active, nonexpired, Grifols Agency Master Services Agreement with the Grifols Talent Acquisition Department. Additionally, agencies may only submit candidates to positions that they have been engaged to work on by a Grifols Recruiter. All resumes must be sent to a Grifols Recruiter under these terms or they will be considered a Grifols candidate. **Grifols provides equal employment opportunities to applicants and employees without regard to race; color; sex; gender identity; sexual orientation; religious practices and observances; national origin; pregnancy, childbirth, or related medical conditions; status as a protected veteran or spouse/family member of a protected veteran; or disability. We will consider for employment all qualified applicants in a manner consistent with the requirements of all applicable laws, including but not limited to, the California Fair Chance Act, the Los Angeles County Fair Chance Ordinance for Employers, and the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance.** Learn more about Grifols ( **Req ID:** 528005 **Type:** Regular Full-Time **Job Category:** Clinical Trials

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Medical Director

83404 Iona, Idaho Grifols Shared Services North America, Inc

Posted today

Job Viewed

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Job Description

Would you like to join an international team working to improve the future of healthcare? Do you want to enhance the lives of millions of people? Grifols is a global healthcare company that since 1909 has been working to improve the health and well-being of people around the world. We are leaders in plasma-derived medicines and transfusion medicine and develop, produce and market innovative medicines, solutions and services in more than 110 countries and regions.
**Position Overview:**
The Medical Director will be responsible for clinical strategy relating to upcoming clinical trials, including indication selection, design of trials, and ongoing medical monitoring of safety signals in trials. This is a remote role and candidate can be located anywhere within the US.
**Responsibilities include, but are not limited to the following:**
+ Design of trials, including study population and eligibility criteria, treatment duration, clinical endpoints, biomarkers, and safety mitigation strategy
+ Serve as the Program Physician for associated clinical trials, addressing patient eligibility and treatment questions in collaboration with the contract research organization (CRO) medical monitor, or directly with study investigators
+ Work closely with preclinical scientists to understand how the biological effects observed in animals can be translated to humans, and use this information to choose the best clinical endpoints and biomarkers for clinical trials
+ Be familiar with the nonclinical safety data (toxicology) and use this information to develop safety mitigation strategies in clinical trial design
+ Serve as a key part of the cross-functional project team, supporting the overall strategy, budget, and timeline of the project
+ Review safety data for individual subjects and trend review for safety signals from ongoing trials
+ Interpret, summarize, and present data from clinical trials to the company and externally
+ Provide strategic input for clinical development plans and regulatory strategy
+ Provide input/review of clinical documents, e.g. protocols, investigator's brochures, case report forms
+ Participate in site/investigator identification and evaluation for clinical trials; conduct site engagement calls and visits
+ Lead preparation of clinical sections of relevant regulatory filings (IND, study reports, NDA, etc.) in cooperation with colleagues in Regulatory Affairs and other functions
+ Serve as program medical expert for internal and external collaborators, investigators, consultants, and contract resources
+ Provide and enhance knowledge in the associated therapeutic area to support global clinical development plans
+ Represent the company at scientific meetings and presentations
+ Attend and provide medical support for investigator and consultant meetings and clinical advisory boards
+ Develop and manage relationships with key opinion leaders to obtain advice and feedback
**Skills/Qualifications/Education Requirements:** (To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, education, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions)
+ Medical Degree
+ Typically requires 8 years of clinical research experience with at least 5 years of clinical document production and/or clinical trial feasibility and strategy or related experience. Additional experience may include other pharmaceutical or academic research in the field.
+ Hands-on experience with clinical trial design, trial conduct and oversight, including medical monitoring for trials in a broad spectrum of indications including medical immunology, hematology, and oncology.
+ Knowledgeable in GCP guidelines in US and Europe
+ Team player with good oral presentation and written skills
+ Collaborative and flexible in personal interactions
+ Ability to work proactively and effectively, with exceptional problem-solving skills
+ Up to 25% travel
_*Depending on the area of assignment, directly related experience or a combination of directly related education and experience and/or competencies may be considered in place of the stated requirements. Example: If a job level requires a Bachelor's degree plus 4 years of experience, an equivalency could include 8 years of experience, an Associate's degree with 6 years of experience, or a Master's degree with 2 years of experience._
If you have the work ethic and mental agility to embrace a fast-paced and rapidly evolving environment, you will be rewarded with diverse and exciting experiences. This is your chance to add real value to an entrepreneurial organization that supports bold innovation and new ideas. Grifols welcomes passionate, team-oriented colleagues who are looking to improve the health of patients worldwide by developing a deeper understanding of human disease.
**Pay Scale:**
The estimated pay scale for the Medical Director (1-2) role based in the United States (non-California), is $170,000.00 - $40,000.00 per year/per hour. Additionally, the position is eligible to participate in 15% - 30% of the company bonus pool (depending on level of role). We offer a wide variety of benefits including, but not limited to: Medical, Dental, Vision, PTO, 9 paid Holidays per year, up to 5% 401(K) match and tuition reimbursement. Final compensation packages will ultimately depend on education, experience, skillset, knowledge, where the role is performed, internal equity and market data. We are committed to offering our employees opportunities for professional growth and career progression. Grifols is a global healthcare organization with employees in 30 countries focused on patient health and providing impactful results. Since our humble beginnings in 1909, Grifols has been a family company that prides itself on its family-like culture. Our company has more than tripled over the last 10 years, and you can grow with us!
**For Washington State:**
Currently, the first year PTO accrual for this role is 160 hours per year. Then, after completion of 365 days of employment the PTO accrual for this role will increase to 180 hours per year.
**For California:**
The estimated pay scale for the Medical Director (1-2) role based in California, is 170,000.00- 250,000.00 per year.
Work is performed in an office environment with exposure to electrical office equipment. Frequently sits for 6-8 hours per day. Repetitive hand movement of both hands with the ability to make fast, simple, repeated movements of the fingers, hands, and wrists. Occasionally walks and stands. Occasionally bends and twists neck. Light to moderate lifting and carrying objects with a maximum lift of 25lbs. Frequently drives to site locations with occasional travel within the United States. Able to communicate information and ideas so others will understand; with the ability to listen to and understand information and ideas presented through spoken and written words and sentences. Interacts with others, relates sensitive information to diverse groups. Must work with diverse groups to obtain consensus on issues.
Third Party Agency and Recruiter Notice:
Agencies that present a candidate to Grifols must have an active, nonexpired, Grifols Agency Master Services Agreement with the Grifols Talent Acquisition Department. Additionally, agencies may only submit candidates to positions that they have been engaged to work on by a Grifols Recruiter. All resumes must be sent to a Grifols Recruiter under these terms or they will be considered a Grifols candidate.
**Grifols provides equal employment opportunities to applicants and employees without regard to race; color; sex; gender identity; sexual orientation; religious practices and observances; national origin; pregnancy, childbirth, or related medical conditions; status as a protected veteran or spouse/family member of a protected veteran; or disability. We will consider for employment all qualified applicants in a manner consistent with the requirements of all applicable laws, including but not limited to, the California Fair Chance Act, the Los Angeles County Fair Chance Ordinance for Employers, and the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance.**
Learn more about Grifols ( ID:** 528005
**Type:** Regular Full-Time
**Job Category:** Clinical Trials
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Medical Records Collector

83401 Idaho Falls, Idaho Molina Healthcare

Posted 1 day ago

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Job Description

JOB DESCRIPTION

Job Summary

Molina's HEDIS/Quality Improvement Medical Records Collector will work collaboratively in outreaching to providers in order to pursue medical records via phone call, fax, mail, electronic medical record system retrieval and direct onsite pick up, for the HEDIS projects.

Job Duties

• Under the direction of the national and/or regional lead, the Medical Records Collector supports the annual HEDIS audit and other HEDIS like audits, by organizing provider outreach, pursuit, collection, and upload of provider medical records into the internal database.

• Assisting with project management by coordinating the identification, pursuit and collection of medical records and other data in collaboration with other HEDIS staff.

• Assists the Manager and Supervisor(s) and / or performs the coordination and preparation of the HEDIS medical record collection process that includes the pursuit via phone call, fax, mail, electronic medical record system retrieval and direct onsite pick up.

• Participates in meetings with vendors for the medical record collection process.

• Collects medical records and reports from provider offices, loads data into the HEDIS application

JOB QUALIFICATIONS

REQUIRED EDUCATION:

High School Diploma or equivalent

REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:

• 1 year customer service experience

• Basic computer skills, including the ability to use Microsoft Office

• Proficiency with data analysis tools (e.g., Excel)

• Ability to manage files, schedules, and information efficiently

REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:

Must have a valid driver’s license with good driving record and be able to drive within applicable state or locality with reliable transportation.

PREFERRED EXPERIENCE:

• 1 season/year medical record collection experience

• 1 year managed care experience

• Basic knowledge of HEDIS and NCQA

• Project planning

PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:

Certified Medical Record Technician

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $21.16 - $31.71 / HOURLY

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

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Medical Director (CT)

83404 Iona, Idaho Molina Healthcare

Posted today

Job Viewed

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Job Description

**JOB DESCRIPTION**
**Job Summary**
Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and implementation of policies and procedures that guide and support the provisions of medical staff services. Maintains a working knowledge of applicable national, state, and local laws and regulatory requirements affecting the medical and clinical staff.
MD licenses required for the following states: WA FL, MI, MS, NM, KY, TX, CA, IL, OH, ID, SC, UT, WI, AZ, MA, NV, IA, GA
**Job Duties**
+ Provides medical oversight and expertise in appropriateness and medical necessity of healthcare services provided to members, targeting improvements in efficiency and satisfaction for patients and providers, as well as meeting or exceeding productivity standards. Educates and interacts with network and group providers and medical managers regarding utilization practices, guideline usage, pharmacy utilization and effective resource management.
+ Develops and implements a Utilization Management program and action plan, which includes strategies that ensure a high quality of patient care, ensuring that patients receive the most appropriate care at the most effective setting. Evaluates the effectiveness of UM practices. Actively monitors for over and under-utilization. Assumes a leadership position relative to knowledge, implementation, training, and supervision of the use of the criteria for medical necessity.
+ Participates in and maintains the integrity of the appeals process, both internally and externally. Responsible for the investigation of adverse incidents and quality of care concerns. Participates in preparation for NCQA and URAC certifications. Develops and provides leadership for NCQA-compliant clinical quality improvement activity (QIA) in collaboration with the clinical lead, the medical director, and quality improvement staff.
+ Facilitates conformance to Medicare, Medicaid, NCQA and other regulatory requirements.
+ Reviews quality referred issues, focused reviews and recommends corrective actions.
+ Conducts retrospective reviews of claims and appeals and resolves grievances related to medical quality of care.
+ Attends or chairs committees as required such as Credentialing, P&T and others as directed by the Chief Medical Officer.
+ Evaluates authorization requests in timely support of nurse reviewers; reviews cases requiring concurrent review, and manages the denial process.
+ Monitors appropriate care and services through continuum among hospitals, skilled nursing facilities and home care to ensure quality, cost-efficiency, and continuity of care.
+ Ensures that medical decisions are rendered by qualified medical personnel, not influenced by fiscal or administrative management considerations, and that the care provided meets the standards for acceptable medical care.
+ Ensures that medical protocols and rules of conduct for plan medical personnel are followed.
+ Develops and implements plan medical policies.
+ Provides implementation support for Quality Improvement activities.
+ Stabilizes, improves and educates the Primary Care Physician and Specialty networks. Monitors practitioner practice patterns and recommends corrective actions if needed.
+ Fosters Clinical Practice Guideline implementation and evidence-based medical practice.
+ Utilizes IT and data analysts to produce tools to report, monitor and improve Utilization Management.
+ Actively participates in regulatory, professional and community activities.
**JOB QUALIFICATIONS**
**REQUIRED EDUCATION:**
+ Doctorate Degree in Medicine
+ Board Certified or eligible in a primary care specialty
**REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:**
+ 3+ years relevant experience, including:
+ 2 years previous experience as a Medical Director in a clinical practice.
+ Current clinical knowledge.
+ Experience demonstrating strong management and communication skills, consensus building and collaborative ability, and financial acumen.
+ Knowledge of applicable state, federal and third party regulations
**REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:**
Current state Medical license without restrictions to practice and free of sanctions from Medicaid or Medicare.
**PREFERRED EDUCATION:**
Master's in Business Administration, Public Health, Healthcare Administration, etc.
**PREFERRED EXPERIENCE:**
+ Peer Review, medical policy/procedure development, provider contracting experience.
+ Experience with NCQA, HEDIS, Medicaid, Medicare and Pharmacy benefit management, Group/IPA practice, capitation, HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment, disease management, and evidence-based guidelines.
+ Experience in Utilization/Quality Program management
+ HMO/Managed care experience
**PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:**
Board Certification (Primary Care preferred).
**PHYSICAL DEMANDS:**
Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $161,914.25 - $315,733 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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Medical Records Collector

83404 Iona, Idaho Molina Healthcare

Posted today

Job Viewed

Tap Again To Close

Job Description

**JOB DESCRIPTION**
**Job Summary**
Molina's HEDIS/Quality Improvement Medical Records Collector will work collaboratively in outreaching to providers in order to pursue medical records via phone call, fax, mail, electronic medical record system retrieval and direct onsite pick up, for the HEDIS projects.
**Job Duties**
- Under the direction of the national and/or regional lead, the Medical Records Collector supports the annual HEDIS audit and other HEDIS like audits, by organizing provider outreach, pursuit, collection, and upload of provider medical records into the internal database.
- Assisting with project management by coordinating the identification, pursuit and collection of medical records and other data in collaboration with other HEDIS staff.
- Assists the Manager and Supervisor(s) and / or performs the coordination and preparation of the HEDIS medical record collection process that includes the pursuit via phone call, fax, mail, electronic medical record system retrieval and direct onsite pick up.
- Participates in meetings with vendors for the medical record collection process.
- Collects medical records and reports from provider offices, loads data into the HEDIS application
**JOB QUALIFICATIONS**
**REQUIRED EDUCATION:**
High School Diploma or equivalent
**REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:**
- 1 year customer service experience
- Basic computer skills, including the ability to use Microsoft Office
- Proficiency with data analysis tools (e.g., Excel)
- Ability to manage files, schedules, and information efficiently
**REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:**
Must have a valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.
**PREFERRED EXPERIENCE:**
- 1 season/year medical record collection experience
- 1 year managed care experience
- Basic knowledge of HEDIS and NCQA
- Project planning
**PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:**
Certified Medical Record Technician
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $21.16 - $31.71 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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Medical Director (Marketplace)

83404 Iona, Idaho Molina Healthcare

Posted today

Job Viewed

Tap Again To Close

Job Description

**JOB DESCRIPTION**
**Job Summary**
Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and implementation of policies and procedures that guide and support the provisions of medical staff services. Maintains a working knowledge of applicable national, state, and local laws and regulatory requirements affecting the medical and clinical staff.
MD licenses required for the following states: WA FL, MI, MS, NM, KY, TX, CA, IL, OH, ID, SC, UT, WI, AZ, MA, NV, IA, GA
**Job Duties**
+ Provides medical oversight and expertise in appropriateness and medical necessity of healthcare services provided to members, targeting improvements in efficiency and satisfaction for patients and providers, as well as meeting or exceeding productivity standards. Educates and interacts with network and group providers and medical managers regarding utilization practices, guideline usage, pharmacy utilization and effective resource management.
+ Develops and implements a Utilization Management program and action plan, which includes strategies that ensure a high quality of patient care, ensuring that patients receive the most appropriate care at the most effective setting. Evaluates the effectiveness of UM practices. Actively monitors for over and under-utilization. Assumes a leadership position relative to knowledge, implementation, training, and supervision of the use of the criteria for medical necessity.
+ Participates in and maintains the integrity of the appeals process, both internally and externally. Responsible for the investigation of adverse incidents and quality of care concerns. Participates in preparation for NCQA and URAC certifications. Develops and provides leadership for NCQA-compliant clinical quality improvement activity (QIA) in collaboration with the clinical lead, the medical director, and quality improvement staff.
+ Facilitates conformance to Medicare, Medicaid, NCQA and other regulatory requirements.
+ Reviews quality referred issues, focused reviews and recommends corrective actions.
+ Conducts retrospective reviews of claims and appeals and resolves grievances related to medical quality of care.
+ Attends or chairs committees as required such as Credentialing, P&T and others as directed by the Chief Medical Officer.
+ Evaluates authorization requests in timely support of nurse reviewers; reviews cases requiring concurrent review, and manages the denial process.
+ Monitors appropriate care and services through continuum among hospitals, skilled nursing facilities and home care to ensure quality, cost-efficiency, and continuity of care.
+ Ensures that medical decisions are rendered by qualified medical personnel, not influenced by fiscal or administrative management considerations, and that the care provided meets the standards for acceptable medical care.
+ Ensures that medical protocols and rules of conduct for plan medical personnel are followed.
+ Develops and implements plan medical policies.
+ Provides implementation support for Quality Improvement activities.
+ Stabilizes, improves and educates the Primary Care Physician and Specialty networks. Monitors practitioner practice patterns and recommends corrective actions if needed.
+ Fosters Clinical Practice Guideline implementation and evidence-based medical practice.
+ Utilizes IT and data analysts to produce tools to report, monitor and improve Utilization Management.
+ Actively participates in regulatory, professional and community activities.
**JOB QUALIFICATIONS**
**REQUIRED EDUCATION:**
+ Doctorate Degree in Medicine
+ Board Certified or eligible in a primary care specialty
**REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:**
+ 3+ years relevant experience, including:
+ 2 years previous experience as a Medical Director in a clinical practice.
+ Current clinical knowledge.
+ Experience demonstrating strong management and communication skills, consensus building and collaborative ability, and financial acumen.
+ Knowledge of applicable state, federal and third party regulations
**REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:**
Current state Medical license without restrictions to practice and free of sanctions from Medicaid or Medicare.
**PREFERRED EDUCATION:**
Master's in Business Administration, Public Health, Healthcare Administration, etc.
**PREFERRED EXPERIENCE:**
+ Peer Review, medical policy/procedure development, provider contracting experience.
+ Experience with NCQA, HEDIS, Medicaid, Medicare and Pharmacy benefit management, Group/IPA practice, capitation, HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment, disease management, and evidence-based guidelines.
+ Experience in Utilization/Quality Program management
+ HMO/Managed care experience
**PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:**
Board Certification (Primary Care preferred).
**PHYSICAL DEMANDS:**
Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $161,914.25 - $315,733 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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Medical Office Coordinator

83404 Iona, Idaho HCA Healthcare

Posted today

Job Viewed

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Job Description

**Description**
Hourly Wage Estimate: $17.44 - $5.30 / hour
Learn more about the benefits offered ( ) for this job.
The estimate displayed represents the typical wage range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role. The typical candidate is hired below midpoint of the range.
**Introduction**
Do you want to join an organization that invests in you as a(an) Medical Office Coordinator? At East Falls Neurosurgery and Spine, you come first. HCA Healthcare has committed up to 300 million in programs to support our incredible team members over the course of three years.
**Benefits**
East Falls Neurosurgery and Spine, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:
+ Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
+ Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
+ Free counseling services and resources for emotional, physical and financial wellbeing
+ 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
+ Employee Stock Purchase Plan with 10% off HCA Healthcare stock
+ Family support through fertility and family building benefits with Progyny and adoption assistance.
+ Referral services for child, elder and pet care, home and auto repair, event planning and more
+ Consumer discounts through Abenity and Consumer Discounts
+ Retirement readiness, rollover assistance services and preferred banking partnerships
+ Education assistance (tuition, student loan, certification support, dependent scholarships)
+ Colleague recognition program
+ Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
+ Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.
Learn more about Employee Benefits ( Eligibility for benefits may vary by location._**
You contribute to our success. Every role has an impact on our patients' lives and you have the opportunity to make a difference. We are looking for a dedicated Medical Office Coordinator like you to be a part of our team.
**Job Summary and Qualifications**
**Full time (Monday - Friday, days), no nights, no on call, no weekends, no holidays**
Seeking a **Medical Office Coordinator** our practice who provides administrative expertise to ensure all patients receive high quality, efficient care. We are an amazing team that works hard to support each other and are seeking a phenomenal addition like you who feels patient care is as meaningful as we do. We want you to apply now.
**What you will do in this role:**
Demonstrates and adheres to the Code of Conduct and Mission and Values statements.
Fosters an engaged culture and values in which all colleagues can thrive
Directly responsible for the efficiency and quality of patient experience relating to patient access via online scheduling, inbound phone calls, and in-person encounters; and ease and accuracy of registration processes, including collection of co-pays and deductibles.
Assists in hiring and selecting clerical and clinical (non-provider) practice staff in partnership with the PM II, III, PA I, or PA II.
Responsible for the appropriate onboarding and timely, comprehensive orientation of non-provider practice staff members in accordance with organizational standards and with shared accountability for first-year non-provider turnover metrics and performance.
Regularly communicate with non-provider staff individually and in staff meetings, emphasizing creating an environment that supports culture and values while encouraging and welcoming the voice of all team members.
Oversees the process of preparing patients for examination and treatment.
Establishes and maintains appropriate processes for managing inbound and outbound patient referrals.
Manages staff scheduling to daily levels appropriate to volume demands and in accordance with the organization's care standards and associated operating metrics.
Assists and provides additional frontline staffing support and coverage to maintain practice operations (answering phones, scheduling, rooming patients, etc.).
Maintains the practice's supply inventory, physical facilities, and core non-provider staffing in ready, functional operating conditions at all times.
Assists in maintaining patient files, records, and other information.
Compiles and condenses technical and statistical data for reports and records pertaining to operational priorities such as scheduling and volume, cancelation and no-show opportunities, etc. Last Update: October 2023
Ensures any patient complaints are handled appropriately and timely (initial response same or next day; findings shared with appropriate members of practice, market/division, and/or other executive leadership).
Participates in professional development activities, including Physician Services manager development curricula and other offerings critical to continued development and readiness for advancement, including (but not limited to) activities such as SPARK pathways and other targeted learnings such as "lunch and learn" sessions hosted at the practice, market, or enterprise level, and other online learning resources (HealthStream, etc.).
Maintains strict confidentiality, always adhering to organizational standards for ethics, compliance, and patient privacy.
Perform other duties as required.
Must adhere to all Physician Services policies and procedures.
**What you will need in this role:**
EDUCATION: High school diploma or GED preferred. Medical Office Specialist or related practice operations certificate preferred.
EXPERIENCE: Two or more years of medical office experience is required
CERTIFICATION/LICENSE: RMA, CMA or LPN certificate is beneficial, CPR Certification is preferred
Supporting HCA Healthcare's 186 hospitals and 2,400+ sites of care, Physician Services plays a crucial role as the main entry point for patients looking for high-quality healthcare within the HCA Healthcare system. With a focus on meeting the needs of our patients at all access points, Physician Services is dedicated to implementing innovative, physician-driven, value-added solutions to assist physicians in providing high-quality, patient-centered care, aligning with our mission to care for and enhance human life.
HCA Healthcare has been recognized as one of the World's Most Ethical Companies® by the Ethisphere Institute more than ten times. ?In recent years, HCA Healthcare spent an estimated $ .7 billion in costs for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.
"Good people beget good people."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder
We are a family 270,000 dedicated professionals! Our Talent Acquisition team is reviewing applications for our Medical Office Coordinator opening. Qualified candidates will be contacted for interviews. **Submit your resume today to join our community of caring!**
We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
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Medical Office Specialist

83404 Iona, Idaho HCA Healthcare

Posted today

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Job Description

**Description**
Hourly Wage Estimate: $15.86 - $2.99 / hour
Learn more about the benefits offered ( ) for this job.
The estimate displayed represents the typical wage range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role. The typical candidate is hired below midpoint of the range.
**Introduction**
Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a(an) Medical Office Specialist with Idaho Physician Services you can be a part of an organization that is devoted to giving back!
**Benefits**
Idaho Physician Services, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:
+ Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
+ Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
+ Free counseling services and resources for emotional, physical and financial wellbeing
+ 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
+ Employee Stock Purchase Plan with 10% off HCA Healthcare stock
+ Family support through fertility and family building benefits with Progyny and adoption assistance.
+ Referral services for child, elder and pet care, home and auto repair, event planning and more
+ Consumer discounts through Abenity and Consumer Discounts
+ Retirement readiness, rollover assistance services and preferred banking partnerships
+ Education assistance (tuition, student loan, certification support, dependent scholarships)
+ Colleague recognition program
+ Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
+ Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.
Learn more about Employee Benefits ( Eligibility for benefits may vary by location._**
Would you like to unlock your potential with a leading healthcare provider dedicated to the growth and development of our colleagues? Join the Idaho Physician Services family! We will give you the tools and resources you need to succeed in our organization. We are looking for an enthusiastic Medical Office Specialist to help us reach our goals. Unlock your potential!
**Job Summary and Qualifications**
**Full time (Monday - Friday, days), no nights, no on call, no weekends, no holidays**
Seeking a **Medical Office Specialist** for our practice who provides clerical expertise to ensure all patients receive high quality, efficient care. We are an amazing team that works hard to support each other and are seeking a phenomenal addition like you who feels patient care is as meaningful as we do. We want you to apply now.
**What you will do in this role:**
You will manage all front office functions including patient relations, check-in/check-out, scheduling, insurance verification, and answering phones
You will manage filing and retrieving medical records and patient information
You will assist with collecting and recording co-pays (cash and/or charge) including balancing the day in the computer
**What Qualifications you will need:**
One year of experience in a medical office setting is preferred
Experience using an EHR system is highly preferred
**Supporting HCA Healthcare's 186 hospitals and 2,400+ sites of care, Physician Services plays a crucial role as the main entry point for patients looking for high-quality healthcare within the HCA Healthcare system. With a focus on meeting the needs of our patients at all access points, Physician Services is dedicated to implementing innovative, physician-driven, value-added solutions to assist physicians in providing high-quality, patient-centered care, aligning with our mission to care for and enhance human life.**
HCA Healthcare has been recognized as one of the World's Most Ethical Companies® by the Ethisphere Institute more than ten times. ?In recent years, HCA Healthcare spent an estimated $ .7 billion in costs for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.
"There is so much good to do in the world and so many different ways to do it."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder
Be a part of an organization that invests in you! We are reviewing applications for our Medical Office Specialist opening. Qualified candidates will be contacted for interviews. Submit your application and help us raise the bar in patient care!
We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
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Senior Medical Director (Medicare)

83404 Iona, Idaho Molina Healthcare

Posted today

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Job Description

**JOB DESCRIPTION**
**Job Summary**
Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and implementation of policies and procedures that guide and support the provision of medical staff services. Maintains a working knowledge of applicable national, state and local laws and regulatory requirements affecting the medical and allied health staff.
**Job Duties**
+ Assists in recruitment, hiring and training of staff as needed.
+ Analyzes data and identifies medical cost savings and quality improvement opportunities.
+ Accounts for regulatory and accreditation performance of assigned team and responds to inquiries, issues and complaints from government and accreditation regulators.
+ Directs the team in providing physician leadership and expertise in the performance of prior authorization, inpatient concurrent review, discharge planning, case management and interdisciplinary care team activities.
+ Ensures that authorization decisions are rendered by qualified medical personnel, without hindrance due to fiscal or administrative incentives
+ Supervises and manages Medical Directors
+ Develops medical policies and procedures
+ Conducts peer review
**JOB QUALIFICATIONS**
**REQUIRED EDUCATION:**
- Doctorate Degree in Medicine
- Board Certified or eligible in a primary care specialty
**REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:**
+ 10+ years relevant experience, including 5+ years of clinical practice and 3+ years HMO/Managed Care experience **OR** 5 years experience as a Molina Medical Director
+ Demonstrated experience in Utilization/Quality Program management
+ Previous leadership experience
+ Peer review, medical policy/procedure development, and provider contracting experience
+ Current clinical knowledge
+ Experience demonstrating strong management and communication skills, consensus building and collaborative ability, and financial acument
+ Knowledge of applicable state, federal and third party regulations
+ Peer review, medical policy/procedure development, and provider contracting experience.
**REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:**
- Current State Medical License without restrictions (free of sanctions from Medicaid or Medicare)
**PREFERRED EDUCATION:**
Master's in Business Administration, Public Health, Healthcare Administration, etc.
**PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:**
Board Certification (Pediatrics, Family Practice, Ob/Gyn or Internal Medicine).
**PHYSICAL DEMANDS:**
Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Pay Range: $214,132 - $417,557 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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