Physician Medical Director Provider Network Management

Danville, Pennsylvania
Sep 08, 2019
Position Type
JOB TITLE: PhysicianMedical Director, Provider Network Management

LOCATION: Danville

DEPARTMENT: Geisinger Health Plan

WORK SCHEDULE: Days/Evenings


Geisinger Health Plan (GHP) is seeking a physician leader, board-certified in family medicine, emergency medicine, or internal medicine, to act as Medical Director, Provider Network Management, working 80% with GHP and 20% in clinical practice. This position will report directly to the Health Plan Chief Medical Officer.

About the position:

· Partner with Provider Network Management Department to engage GHP's network physicians to improve the health of member through enhanced member experience, quality of care, and efficient use of resources.

· Work closely with all Health Plan Medical Directors to further GHP's goals.

· Provide guidance and interpretation on issues of medical appropriateness, benefit application, and level of care necessary as needed to assist in answering questions, queries and appropriateness from providers.

· Participate in Medical Director On-Call and On-Duty and Appeals Committee activities as necessary.

The ideal physician candidate will have 3-5 years of clinical experience with previous experience as a medical director in a managed care organization and an advanced degree in business or healthcare administration desirable but not required. Dedication to the philosophy of managed care and continuous quality improvement of clinical care and services, is a must.

Geisinger Health Plan (GHP) is the health insurance component of Geisinger Health System and serves over 460,000 members in Pennsylvania and West Virginia. Begun in 1985, GHP provides high quality, affordable health-care benefits for businesses of all sizes, individuals and families, and Medicare beneficiaries*.

*PPO and high deductible plans are sold through Geisinger Quality Options, Inc. Self-funded plans are sold through Geisinger Indemnity Insurance Company.

For more information, please visit or contact: Rebecca Grubb, Talent Acquisition Specialist, 570-271-6552 or

OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation.

GEISINGER HEALTH PLAN (GHP) is the health insurance component of Geisinger and serves over 460,000 members in Pennsylvania and West Virginia. Begun in 1985, GHP provides high quality, affordable health-care benefits for businesses of all sizes, individuals and families, and Medicare beneficiaries.

About Geisinger: Geisinger is a physician-led health system comprised of approximately 30,000 employees, including nearly 1,600 employed physicians, 13 hospital campuses, two research centers, and a 583,000-member health plan Geisinger is nationally recognized for innovative practices and quality care. Geisinger serves more than 3 million people in central, south-central and northeast Pennsylvania and also in southern New Jersey with the addition of National Malcolm Baldridge Award recipient AtlantiCare, A member of Geisinger. In 2017, the Geisinger Commonwealth School of Medicine became the newest member of the Geisinger Family.

We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners.* Perhaps just as important, from senior management on down, we encourage an atmosphere of collaboration, cooperation and collegiality. For more information, visit, or connect with us on Facebook, Instagram, LinkedIn and Twitter.

** Does not qualify for J-1 waiver. We are an Affirmative Action, Equal Opportunity Employer Women and Minorities are Encouraged to Apply. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of disability or their protected veteran status.

*Domestic partner benefits not applicable at Geisinger Holy Spirit.

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