Director Medical Job Description
Director Medical Duties & Responsibilities
To write an effective director medical job description, begin by listing detailed duties, responsibilities and expectations. We have included director medical job description templates that you can modify and use.
Sample responsibilities for this position include:
Director Medical Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Director Medical
List any licenses or certifications required by the position: CPR, URAC, NCQA, ACLS, BLS, DEA, M.D, CA, ISO
Education for Director Medical
Typically a job would require a certain level of education.
Employers hiring for the director medical job most commonly would prefer for their future employee to have a relevant degree such as Doctorate and University Degree in Medical, Medicine, Medical School, Graduate, Education, Management, Internal Medicine, Psychiatry, Technical, Public Health
Skills for Director Medical
Desired skills for director medical include:
Desired experience for director medical includes:
Director Medical Examples
Director Medical Job Description
- Participates in nurse case management review
- Attends case review round tables
- Manages utilization review decisions when questions arise
- Defines medical policies and protocols
- Contributes to the decisions for reserves on special cases
- Reviews high cost issues and directs independent medical examinations of claimants as warranted
- Directs, develops and participates in the medical education of Claims Services Representatives, Medical Care Representatives and other Department staff to reinforce the understanding of new technologies and applications currently being requested by the medical community
- Acts as NYSIF’s liaison to the medical community
- Interfaces with clients as a medical expert
- Promotes sound medical case management to address medical claims issues that have unexpected indemnity losses and/or problematic return-to-work issues
- Pharmaceutical product development, product lifecycle and commercialization process with advanced understanding of other functions
- Board certification/eligibility in specialty area desired but not required
- Strong track record in drug development preferably in a variety of therapeutic areas
- Current board certification (Internal Medicine) in an ABMS or AOA recognized specialty (grandfathered by the board or maintained by the MOC program)
- Graduate of a recognized medical school and recipient of an M.D
- MD required, subspecialty training in GI, cardiology, or nephrology is preferred
Director Medical Job Description
- Provide training, follow-up support and supportive supervision as necessary with activities and develop evidence-based, gender-appropriate clinical training materials and standards, supervisory systems, and other materials needed for implementation in relation to HIV/AIDS
- Drive vendor direction and change as needed
- Work with external providers and facilities on programs to ensure appropriate utilization of health care resources
- Conduct problem solving the scope and frequency of these opportunities is diverse, frequently involving coordination with internal and external customers
- Oversee all aspects of psychiatric care including evaluation, medication, crisis
- Lead quality improvement projects and facilitate implementation of systemic change
- Identify and help to implement innovative clinic practices
- Create implement, and assess treatment processes and procedures
- Provide organizational leadership in the operational areas of utilization review, case management, quality improvement and related policy and practice initiatives
- Incumbent will serve as the lead physician for the Plan working closely with other medical management team members
- Demonstrated knowledge and experience of interaction of medical policy with other Plan functions (legal, marketing, media, government relations, provider contracting )
- Medical advice
- Exhibits behaviors outlined in the Employee Behaviors
- Medical degree with 5 years of well-rounded professional experience
- MD or DO with an unrestricted PA, WV, DE medical license
- Board certified in an American Board of Medical Specialties or Bureau of Osteopathic Specialists recognized specialty
Director Medical Job Description
- Author clinical sections of IND’s, Investigator Brochures, CTA’s, ISS’s, ISE’s and clinical expert reports
- Provide medical management and expertise for clinical trials
- Manage safety issues in clinical trials and work closely with associates in evaluation and assessment of the trials
- Recommending and implementing clinical policies and procedures
- Supervising a small clinical staff in their medical and nursing duties
- Ensuring continuous quality improvement in all clinical activities
- May assist in outside presentations or provider recruitment and retention
- Responsible for chairing appropriate health services committees, providing leadership for pharmacy and health services utilization management projects, and assisting in the development and maintenance of medical management projects
- Provides support and guidance for appeals, medical, Long Term Services and Supports, and medication prior-authorization requests, and benefit designs and levels
- Assists in working with other divisions for managing Medicare/Medicaid, as applicable, requirements
- Minimum, at least five years of direct patient care experience
- Graduate degree such as an MBA or MPH
- Nephrologist with a background in renal acute/chronic
- Demonstrated advanced organizational skills
- Demonstrated advanced ability to deal with confidential information
- Demonstrated advanced negotiation skills
Director Medical Job Description
- Support strategic alignment of the assigned clinical program working cross functionally and partnering with other key functions as outlined
- Serve on cross-functional study execution teams (SET) for assigned trials, working with other team members to achieve efficient, high-quality study execution and to function as medical lead and medical monitor for global phase 3b/4 clinical trials
- Responsible for medical interpretation of data (clinical trials, registries, published literature, ) for in-development and/or marketed compounds
- Align Global Medical Affairs objectives with those of Clinical Development and Commercial operations to ensure programs meet the needs of all stakeholders
- Hold overall accountability for the management of the medical department, which includes medical science liaisons management, pharmacovigilance and clinical trials within the Affiliate
- Keeps product and development project information up to date based on internal and external publications
- Keeps close interaction and communicates with Global and Country medical affairs functions
- Play key role in supervising the planning and implementation of all project activities, ensuring that all activities are properly and timely performed and that outputs are accomplished and delivered according to the agreed work plans
- Lead assessments and analysis of baseline studies that impede access to care, and the development and testing of appropriate strategies for long-term, sustainable resolution
- Lead performance improvement/quality improvement interventions in collaboration with HQ
- Advanced ability to remain calm under pressure
- Must be able to apply medical knowledge and principles to business challenges in order to achieve significant member, business, and quality outcomes
- Must be detail-oriented and have a “hands-on” approach
- 2+ years full-time experience practicing medicine
- Knowledge of Plan policy implementation, claims operations and provider and account relations
- Degree in medicine from an accredited school and is licensed to practice medicine (Doctor of Medicine or Doctor of Osteopathic Medicine.)
Director Medical Job Description
- Serves as the chief subject matter expert for all staff regarding the clinical aspects of IMR
- Performs clinical reviews of IMR cases (~50% of hours billed)
- Contributes clinical expertise for the development of new business
- Manage and maintain monthly and quarterly technical assistance plans for the project
- Manage project monitoring and evaluation efforts and the project's performance monitoring plan
- Participate in new business development through involvement in proposal and sponsor meetings as requested
- Coordinate with other departments in all phases of the studies and trials including feasibility assessments, design processes, educational efforts, management of medical information, and reviewing and editing of medical documents
- Follow specific research related protocol and lead others in strict adherence to the policies
- Chart audit and peer review
- Acting as an integral part of the management team
- Medical license must be active and unrestricted
- Board Certification in AMBS specialty
- At least 5 years of hands-on patient management in licensed discipline
- Board certification in an appropriate specialty as recognized by the American Board of Medical Specialties (ABMS) or equivalent training and/or experience (certification must be maintained during the tenure as Medical Director)
- General knowledge of the requirements and application of the Health Insurance Portability and Accountability Act (HIPAA) and patient care documentation standards
- The ability to meet the physical requirements of the position, including the ability to sit, bend, stoop, walk, and stand for extended periods of time