Requisition #: 184442
Location: Johns Hopkins Health Care, Hanover, MD
Work Shift: Day Shift
Work Week: Full Time (40 hours)
Weekend Work Required: No
Date Posted: April 22, 2019
Johns Hopkins Health System employs more than 20,000 people annually. Upon joining Johns Hopkins Health System, you become part of a diverse organization dedicated to its patients, their families, and the community we serve, as well as to our employees.
Career opportunities are available in academic and community hospital settings, home care services, physician practices, international affiliate locations and in the health insurance industry. If you share in our vision, mission and values and also have exceptional customer service and technical skills, we invite you to join those who are leaders and innovators in the healthcare field.
The Medical Director of Johns Hopkins HealthCare LLC (JHHC) will work under the direction of the Chief Medical Officer (CMO) of JHHC and work with the other Medical Directors. The Medical Director will also coordinate activities with the President and Chief Executive Officer of JHHC.
The Medical Director will be responsible to ensure that the provision of health care service to the membership is compliant with the medical policies and standards established by the Medical Policy Committee. This will be accomplished by participating in reviews Pre-Service, Appeals and In-Patient Care. Working with the CMO, the Medical Director will propose policies and standards for review and resolution to the committee and communicate these policies and standards to physicians participating in the JHHC program.
The Medical Director will work with the Assistant Vice President of Health Services for JHHC and other Medical Directors to oversee all activities of utilization review, care management and quality to determine the medical effectiveness of proposed treatments and approve care management plans. The critical responsibility will be the management of care delivery in a cost effective and quality assured system that will assist JHHC to achieve its corporate mission of serving the health needs of enrollees.
This position requires a Medical Degree from an accredited medical school; MBA, MPH, or similar preferred. Unrestricted license as M.D.
If licensed outside of Maryland, must be willing to apply for a Maryland M.D. license and receive one within four months of employment. Board Certified in a clinical specialty required. This position requires five years experience in managed care, care management, and medical policy development.
Experience with Medicaid preferred. Some clinical practice experience preferred.
Johns Hopkins Medicine