DIRECTOR - MEDICAL DIRECTOR - ASPIRUS HEALTH PLAN

The Medical Director is responsible for conducting day-to-day medical management and leading ongoing improvement initiatives in collaboration with the Director of Operations, Quality Improvement Specialist, and Utilization Management. The role involves providing support and consultation for utilization management (medical and pharmacy), appeals, medical policy (development and maintenance), and quality improvement (Medicare Stars, NCQA). The Medical Director ensures that Aspirus Health Plan members receive care that is safe, timely, effective, efficient, patient-centered, and equitable. Support and help to lead aspects of regulatory compliance that relate to clinical functions and programs. Provide clinical support as needed to staff throughout Aspirus Inc.: e.g., complex case management, disease management vendors and delegates. Experience/Qualifications: • Current MD or DO degree with an unencumbered and unrestricted license to practice medicine in Wisconsin and Michigan. • Current Board Certification in a specialty recognized by the American Board of Medical Specialties or the American Osteopathic Association. • Minimum of five years of clinical experience post-residency. • Experience in internal medicine, family medicine, or emergency medicine required. • Experience in specialty areas such as oncology, rehabilitation, and physical medicine preferred. • Minimum of five years of healthcare administration, including utilization management Employee Benefits • Full benefits packages available for part- and full-time status. • PTO accrual from day one! • Generous retirement plan with match available. • Wellness program for employees and their families.