Opening for Medical Director of Managed Care in Denver!

Denver Health & Hospital Authority (DHHA) in the heart of thriving downtown Denver, Colorado, is recruiting for a Medical Director of Managed Care. The Medical Director of Managed Care serves as the Denver Health Medical Plan’s Chief Medical Officer and is responsible for the overall vision, development, implementation, and evaluation of medical management activities carried out by Managed Care on behalf of its members. The overarching goals of these activities are to improve member care and outcomes, reduce unnecessary health care expenses, and insure that clinical services are provided in a manner consistent with each health plan’s benefits.

The Medical Director oversees activities of the following Managed Care Departments: Pharmacy, Behavioral Health, and Wellness, Quality Improvement & Accreditation, Utilization Management/Case Management. The incumbent also serves as a liaison to all of the clinical departments at Denver Health. In this capacity, the Medical Director is responsible for educating Denver Health’s clinical providers about the Medical Plan’s benefit plans and management resources, including how to refer members in need of those resources, request prior authorization approval, and how to collaborate with Managed Care to meet our shared goals and objectives.

The Medical Director is responsible for helping coordinate Managed Care’s medical management initiatives with the clinical activities in Denver Health’s inpatient and outpatient settings. The Medical Director is a member of key Denver Health and Ambulatory Care Services (ACS) committees such as the Directors of Service Committee, Medical Staff Executive Committee, Executive Committee of Patient Safety and Quality, the Integrated Pharmacy and Therapeutic Committee, and ACS’s Clinical Design Team.

Education: MD/DO required. Board certified or eligible in the primary specialty appropriate for their division: advance degrees or certifications (e.g., MPH, MBA) desirable.

Experience: Minimum of five years of clinical practice. Three years of managed care experience (either in a medical group or health plan) in medical cost/utilization management, population health, disease management, health care quality improvement programs, clinical guideline development and implementation.

Generous benefits at Denver Health include:

• Competitive salary
• Robust retirement package
• Relocation assistance
• Conveniently located in Denver with access to a thriving cultural scene, diverse neighborhoods, natural beauty, mountains, trails, and 300+ days of sunshine per year 

Interested candidates should submit their curriculum vitae to:
Aaron Ortiz, Sr. Physician Recruiter
aaron.ortiz@dhha.org

303-602-4992