Director, Medical WTC

Logistics Health   •  

La Crosse, WI

Industry: Healthcare IT

  •  

5 - 7 years

Posted 346 days ago

JOB SUMMARY

Physician leader across multiple departments, primarily interacting with clinical leaders, nurse case managers, medical assistants, social workers and administrative team members as well as external client.  Serves as subject matter expert for clinical teams that review client's medical records and/or interact with members according to contract requirements.  Medical liaison for internal and external customer needs. 

Ensures medical quality standards are met based on contract requirements
Provides utilization review services and medical certification of contract members in response to requests from case managers
Participates in credentialing reviews and clinical qualification approval for providers and practitioners in the National Provider Network
Guides clinical training for LHI's contracted providers and practitioners in the National Provider Network with regard to the WTC contract; supports WTC Program Manager and supervisors in clinical training of internal staff, including initial and ongoing education
Travels to and represents LHI at monthly WTC steering committee meetings
Acts as the LHI medical liaison to NIOSH physicians
Participates in internal and external WTC meetings and conference calls, which could entail preparation and presentation of reports
Maintains proficiency in medical director duties for other contracts, serving in a support role for other LHI medical directors at the discretion of the CMO, which could include travel and participation in medical services at group events
Provides medical consultation based on review of physical and behavioral health exams, lab results, EKGs, PFTs, other practitioner documentation and specialty exams, primarily for utilization review purposes but also in a support role of other contracts
Maintains active communication with the CMO and other LHI medical directors with regard to the status of medical issues pertaining to the WTC contract
Contributes medical expertise in creation of technical proposals for a variety of business opportunities as assigned by the CMO
Represents LHI during collaboration with entities at UHG and Optum, at the discretion of the CMO
Responsible for reviewing NIOSH clinical policy and working with WTC Program Manager to ensure LHI adherence; develop and implement internal training to support clinical policy
Development and implementation of member care audit plan


JOB QUALIFICATIONS

Required:

Accredited Board Certified MD or DO
WI state licensure
Current and unrestricted licensure, with the potential to obtain licensure in multiple states
Minimum of 4 years of medical experience with an emphasis on general medicine
Minimum of 2 years of leadership experience
Active clinical practice or medical management within the past 5 years
Excellent written and verbal communication skills
Equivalent combination of education, experience and/or applicable military experience will be considered

Preferred:

Experience in occupational medicine
Intermediate Computer Skills
Military Experience
Corporate structure awareness
National Career Readiness Certificate

 

Position will remain open until filled. 


At LHI you'll enjoy a robust benefits package.

Here are some of the benefits you'll enjoy as an employee of LHI at our La Crosse location:
Health, dental and vision insurance
401(k) plan with matching contributions up to 4%
Basic and supplemental life insurance
Long- and short-term disability
Competitive pay, including incentive opportunities
Paid time off, holidays and bereavement
Health care and dependent care flex spending accounts
Child care and fitness club reimbursement
Employee referral program

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