Medical Director, CHRISTUS Health Plans Job in Irving
The Medical Director will provide leadership to Utilization Management (UM) teams across Christus Health Plans. This leader will perform medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services. Provides medical leadership for utilization management, care management, cost containment, and medical quality improvement activities. This leader will work collaboratively with Utilization Management, Care Management (CM), and Pharmacy Benefits and Services leaders, as well as non-clinical team members to deliver high-quality utilization management services.
- Three to five years of experience in a clinical setting – required
- One to three years of experience as a UM Medical Director, Physician Advisor, or equivalent – required
- One to three years of experience in leadership and/or management roles - preferred
- MD or DO degree from an accredited medical school.
Licenses, Registrations or Certifications:
- Current and active license to practice clinical medicine in Texas – required.
- Current Board Certification in a clinical specialty – required.
Major Job Responsibilities:
- Able to work in a highly matrixed environment and comfortable achieving results through influence, collaboration, and positive relationship development.
- Excellent facilitation, conflict resolution and interpersonal skills.
- Transactional medical necessity reviews.
- Excellent verbal and written skills.
- Ability to be flexible and adapt to unique site needs.
- Comfortable providing in person communication and presentation in front of large groups.
- Demonstrates patient/customer focused, compassionate behavior.
- Takes responsibility for decisions, actions, and results and delivers on commitments.
- Manages complex, cross functional projects.
- Practices financial stewardship of resources.
- Cooperates and collaborates with team members and others.
- Complies with the Employee Conduct of Conduct and all other policies and procedures.
- Demonstrates compliance with all federal, state, and local laws and regulations.
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