{"id":14767,"date":"2024-05-23T05:27:07","date_gmt":"2024-05-23T05:27:07","guid":{"rendered":"https:\/\/exam4sure.com\/jobs\/?p=14767"},"modified":"2024-05-23T05:27:07","modified_gmt":"2024-05-23T05:27:07","slug":"remote-medical-director-new-york","status":"publish","type":"post","link":"https:\/\/exam4sure.com\/jobs\/remote-medical-director-new-york\/","title":{"rendered":"Remote Medical Director &#8211; New York"},"content":{"rendered":"<div class=\"flex flex-col gap-8\">\n<div>\n<div>\n<div>\n<div>\n<div>\n<div><span style=\"font-family: Roboto, sans-serif; font-size: 18px; font-weight: bold;\">Description<\/span><\/div>\n<h4><a href=\"https:\/\/joblagii.com\/company\/centene\">Remote Medical Director &#8211; New York<\/a><\/h4>\n<div><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"job_description whitespace-pre-line break-words\">\n<div>\n<p>You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management\/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.<\/p>\n<p><strong>Position Purpose:<\/strong>\u00a0Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit.<\/p>\n<h4><a href=\"https:\/\/joblagii.com\/company\/centene\">Remote Medical Director &#8211; New York<\/a><\/h4>\n<ul>\n<li>Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities.<\/li>\n<\/ul>\n<ul>\n<li>Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services, ensuring timely and quality decision making.<\/li>\n<\/ul>\n<ul>\n<li>Supports effective implementation of performance improvement initiatives for capitated providers.<\/li>\n<\/ul>\n<ul>\n<li>Assists Chief Medical Director in planning and establishing goals and policies to improve quality and cost-effectiveness of care and service for members.<\/li>\n<\/ul>\n<ul>\n<li>Provides medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate, and accreditation requirements.<\/li>\n<\/ul>\n<ul>\n<li>Assists the Chief Medical Director in the functioning of the physician committees including committee structure, processes, and membership.<\/li>\n<\/ul>\n<h4><a href=\"https:\/\/joblagii.com\/company\/centene\">Remote Medical Director &#8211; New York<\/a><\/h4>\n<ul>\n<li>Conduct regular rounds to assess and coordinate care for high-risk patients, collaborating with care management teams to optimize outcomes.<\/li>\n<\/ul>\n<ul>\n<li>Collaborates effectively with clinical teams, network providers, appeals team, medical and pharmacy consultants for reviewing complex cases and medical necessity appeals.<\/li>\n<\/ul>\n<ul>\n<li>Participates in provider network development and new market expansion as appropriate.<\/li>\n<\/ul>\n<ul>\n<li>Assists in the development and implementation of physician education with respect to clinical issues and policies.<\/li>\n<\/ul>\n<ul>\n<li>Identifies utilization review studies and evaluates adverse trends in utilization of medical services, unusual provider practice patterns, and adequacy of benefit\/payment components.<\/li>\n<\/ul>\n<ul>\n<li>Identifies clinical quality improvement studies to assist in reducing unwarranted variation in clinical practice in order to improve the quality and cost of care.<\/li>\n<\/ul>\n<h4><a href=\"https:\/\/joblagii.com\/company\/centene\">Remote Medical Director &#8211; New York<\/a><\/h4>\n<ul>\n<li>Interfaces with physicians and other providers in order to facilitate implementation of recommendations to providers that would improve utilization and health care quality.<\/li>\n<\/ul>\n<ul>\n<li>Reviews claims involving complex, controversial, or unusual or new services in order to determine medical necessity and appropriate payment.<\/li>\n<\/ul>\n<ul>\n<li>Develops alliances with the provider community through the development and implementation of the medical management programs.<\/li>\n<\/ul>\n<ul>\n<li>As needed, may represent the business unit before various publics both locally and nationally on medical philosophy, policies, and related issues.<\/li>\n<\/ul>\n<ul>\n<li>Represents the business unit at appropriate state committees and other ad hoc committees.<\/li>\n<\/ul>\n<h4><a href=\"https:\/\/joblagii.com\/company\/centene\">Remote Medical Director &#8211; New York<\/a><\/h4>\n<p><strong>Education\/Experience:<\/strong>\u00a0Medical Doctor or Doctor of Osteopathy. Utilization Management experience and knowledge of quality accreditation standards preferred. Actively practices medicine. Course work in the areas of Health Administration, Health Financing, Insurance, and\/or Personnel Management is advantageous. Experience treating or managing care for a culturally diverse population preferred.<\/p>\n<p><strong>License\/Certifications:<\/strong><\/p>\n<h4><a href=\"https:\/\/joblagii.com\/company\/centene\">Remote Medical Director &#8211; New York<\/a><\/h4>\n<p>Board certification in a medical specialty recognized by the American Board of Medical Specialists or the American Osteopathic Association\u2019s Department of Certifying Board Services. Current New York state license as a MD or DO without restrictions, limitations, or sanctions from government programs.<\/p>\n<\/div>\n<\/div>\n<div class=\"mb-8 flex items-center justify-between\">\n<div class=\"mb-8 flex items-center justify-between\">\n<div class=\"job-sidebar\">\n<h2 style=\"text-align: center;\">Remote Medical Director &#8211; New York<\/h2>\n<\/div>\n<div class=\"container\">\n<div id=\"js-job-share\" class=\"job-share\">\n<div class=\"inner\"><\/div>\n<\/div>\n<\/div>\n<section class=\"ph-widget\" data-ph-id=\"ph-page-element-page19-quNRJj\">\n<div class=\"ph-job-details-v1-job-fields-default ph-widget-target au-target\" data-widget=\"ph-job-details-v1\" data-ph-id=\"ph-page-element-page19-neFKxw\">\n<div class=\"job-other-info\" data-ph-at-id=\"job-info\" data-ph-id=\"ph-job-fields-1589714855419-ph-job-details-v1eb0ddh-E9Pywe\">\n<div class=\"job-smart-tags\" data-ph-id=\"ph-job-fields-1589714855419-ph-job-details-v1eb0ddh-Nj5d53\">\n<div class=\"au-target job-tag-area style-1\" data-ph-id=\"ph-job-fields-1589714855419-ph-job-details-v1eb0ddh-a1vaBu\"><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/section>\n<section class=\"ph-widget\" data-ph-id=\"ph-page-element-page19-quNRJj\">\n<div class=\"ph-job-details-v1-job-fields-default ph-widget-target au-target\" data-widget=\"ph-job-details-v1\" data-ph-id=\"ph-page-element-page19-neFKxw\">\n<div class=\"job-other-info\" data-ph-at-id=\"job-info\" data-ph-id=\"ph-job-fields-1589714855419-ph-job-details-v1eb0ddh-E9Pywe\">\n<div class=\"job-smart-tags\" data-ph-id=\"ph-job-fields-1589714855419-ph-job-details-v1eb0ddh-Nj5d53\">\n<div class=\"au-target job-tag-area style-1\" data-ph-id=\"ph-job-fields-1589714855419-ph-job-details-v1eb0ddh-a1vaBu\"><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/section>\n<\/div>\n<\/div>\n<h4>\u201cTop 10 Interview Questions\u201d<\/h4>\n<ul>\n<li>Can you tell us about yourself?<\/li>\n<li>What interests you about this position?<\/li>\n<li>What are your strengths?<\/li>\n<li>What are your weaknesses?<\/li>\n<li>Can you give an example of a time when you solved a problem creatively?<\/li>\n<li>How do you handle stress and pressure?<\/li>\n<li>How would you describe your work style?<\/li>\n<li>Can you tell us about a time when you had to work with a difficult<\/li>\n<li>colleague or supervisor?<\/li>\n<li>How do you stay organized and prioritize tasks?<\/li>\n<li>What are your long-term career goals?<\/li>\n<\/ul>\n<h4>Document Required:<\/h4>\n<ul>\n<li>Required Documents for This Recruitment: The candidate should have this Document Before Apply Online. Candidates Are Suggested To Read<\/li>\n<li>the Official Notification Before Applying.<\/li>\n<li>Document \u2013 Qualifications certificate with mark sheets.<\/li>\n<li>Passport size Photographs<\/li>\n<li>Signature<\/li>\n<\/ul>\n<h4 style=\"text-align: left;\">How to apply:<\/h4>\n<ul>\n<li>All the eligible candidates can apply for This Job as mentioned below<\/li>\n<li>Read the official notification carefully From the Official Website.<\/li>\n<li>Read the Notification Carefully Before Applying.<\/li>\n<li>Fill out The Application Form (The link Is Given Below)<\/li>\n<li>Attach the Required Document and Passport Size Photo with Signature.<\/li>\n<li>Then Submit. Done.<\/li>\n<\/ul>\n<div class=\"mb-8 flex items-center justify-between\">\n<div class=\"mb-8 flex items-center justify-between\">\n<h4 data-ph-id=\"ph-page-element-page19-48ZcKJ\"><\/h4>\n<div class=\"job-sidebar\">\n<h3 style=\"text-align: center;\">Remote Medical Director &#8211; New York<\/h3>\n<\/div>\n<\/div>\n<\/div>\n<p style=\"text-align: center;\"><a href=\"https:\/\/joblagii.com\/company\/centene\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-1843\" src=\"https:\/\/exam4sure.com\/jobs\/wp-content\/uploads\/2023\/12\/appy-1-300x116.jpg\" alt=\"\" width=\"300\" height=\"116\" \/><\/a><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Description Remote Medical Director &#8211; New York You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management\/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose:\u00a0Assist the Chief Medical Director to direct and [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":1043,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[779,1,108],"tags":[780],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.2 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Remote Medical Director - New York<\/title>\n<meta name=\"description\" content=\"Remote Medical Director - New York, work from home job online assistant job work from home jobs\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/exam4sure.com\/jobs\/remote-medical-director-new-york\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Remote Medical Director - New York\" \/>\n<meta property=\"og:description\" content=\"Remote Medical Director - New York, work from home job online assistant job work from home jobs\" \/>\n<meta property=\"og:url\" content=\"https:\/\/exam4sure.com\/jobs\/remote-medical-director-new-york\/\" \/>\n<meta property=\"og:site_name\" content=\"Latest Remote Jobs in USA\" \/>\n<meta property=\"article:published_time\" content=\"2024-05-23T05:27:07+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/exam4sure.com\/jobs\/wp-content\/uploads\/2023\/07\/remote-jobs.jpeg\" \/>\n\t<meta property=\"og:image:width\" content=\"1024\" \/>\n\t<meta property=\"og:image:height\" content=\"512\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"exam4sure@blogadmin\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"exam4sure@blogadmin\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"4 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/exam4sure.com\/jobs\/remote-medical-director-new-york\/\",\"url\":\"https:\/\/exam4sure.com\/jobs\/remote-medical-director-new-york\/\",\"name\":\"Remote Medical Director - New York\",\"isPartOf\":{\"@id\":\"https:\/\/exam4sure.com\/jobs\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/exam4sure.com\/jobs\/remote-medical-director-new-york\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/exam4sure.com\/jobs\/remote-medical-director-new-york\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/exam4sure.com\/jobs\/wp-content\/uploads\/2023\/07\/remote-jobs.jpeg\",\"datePublished\":\"2024-05-23T05:27:07+00:00\",\"dateModified\":\"2024-05-23T05:27:07+00:00\",\"author\":{\"@id\":\"https:\/\/exam4sure.com\/jobs\/#\/schema\/person\/911705547976b87bb88c5b29925ed074\"},\"description\":\"Remote Medical Director - New York, work from home job online assistant job work from home jobs\",\"breadcrumb\":{\"@id\":\"https:\/\/exam4sure.com\/jobs\/remote-medical-director-new-york\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/exam4sure.com\/jobs\/remote-medical-director-new-york\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/exam4sure.com\/jobs\/remote-medical-director-new-york\/#primaryimage\",\"url\":\"https:\/\/exam4sure.com\/jobs\/wp-content\/uploads\/2023\/07\/remote-jobs.jpeg\",\"contentUrl\":\"https:\/\/exam4sure.com\/jobs\/wp-content\/uploads\/2023\/07\/remote-jobs.jpeg\",\"width\":1024,\"height\":512,\"caption\":\"Staff Solar Technician\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/exam4sure.com\/jobs\/remote-medical-director-new-york\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/exam4sure.com\/jobs\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Remote Medical Director &#8211; 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