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Accede Solutions Inc (accedesolution.com)
Quality Medical DirectorAccede Solutions Inc (accedesolution.com) • Jackson, MS, United States
Quality Medical Director

Quality Medical Director

Accede Solutions Inc (accedesolution.com) • Jackson, MS, United States
19 days ago
Job type
  • Full-time
Job description

Quality Medical Director

Primary Function: As the Quality Medical Director, you will oversee Client's Mississippi Quality Assurance team to ensure the proper provision of program services. You will serve as a clinical liaison for quality management and improvement activities for the FFS and Mississippi CAN programs.

Essential Functions:

  • Oversee and have accountability for the medical review activities of the organization or assigned contracts.
  • Conduct critical peer reviews to ensure the health provided is appropriate and necessary.
  • Instruct other physician reviewers on critical reviews and improvement of health care.
  • Assist Client staff with training physician reviewers regarding their responsibilities and functions.
  • Serve as a technical expert on the peer review process.
  • Participate in advisory panels as recommended.
  • Represent Client policies and procedures to medical and non-medical persons.
  • Participate in committee meetings representing Client.

Requirements:

  • 3+ years of managing and/or working with Medicaid, government health plans, or authorization programs.
  • Current unrestricted MD or DO license in the state of Mississippi.
  • Current and active, unrestricted United States board certification by the American Board of Medical Specialties or Advisory Board of Osteopathic Medicine.
  • Post-graduate experience in direct clinical patient care.
  • Experience with Medicaid is highly preferred.
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Quality Medical Director • Jackson, MS, United States

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