Medical Director Opportunity at Growing Health Plan in Las Vegas

We are recruiting a Medical Director for the largest union health plan in Las Vegas. The position will support the planning, implementation, and operations of health centers for members as well as provide physician leadership for healthcare operations for the union health fund. The Medical Director will also lead medical management, utilization review, quality improvement, provider outreach, and discovery and adoption of innovations in these areas.

This is an excellent opportunity to be a part of a cohesive leadership team implementing a cutting-edge vision of healthcare services for a deserving patient population. The health plan is in the midst of a major investment to expand clinical locations and build infrastructure focused on population health management.

Qualifications:

• 7 + Years of direct clinical practice experience coupled with participating in a leadership role in a medical, insurance, or other related organization responsible for managing healthcare delivery systems
• General knowledge of coverage benefits and rules and regulations; experience in medical policy analysis, development, and implementation, and in quality assessment/improvement activities
• In depth knowledge of integrated delivery system development including PCMH and ACO principles
• Strong understanding of healthcare trends and statistical measures of healthcare performance
• Familiarity with managed care environments
• Strong understanding of current benefits legislation, e.g., ERISA, DOL, IRS, COBRA, HIPAA, etc.
• In-depth understanding of utilization review, disease and demand management, clinical guideline development, provider contracting, physician profiling, pharmacy and therapeutic programs, outcomes measurement, and   performance improvement
• Required: MD or DO
• Bilingual in Spanish preferred but not required

Benefits:

• This generous benefits package includes salary, a strong defined pension plan, generous paid time off policy, exceptional and low-cost medical, dental, and vision insurance plans
• No income tax in Nevada