Medical Director Responsible for clinical Doctor of Medicine 5 Des Moines, direction of medical (MD) or D.O. from an IA services and quality accredited school of improvement functions at medicine recognized by the health plan. Provides national medical medical management regulatory bodies in the leadership and, as United States applicable, manages all An unrestricted and major clinical and quality current license to practice program components medicine in Iowa under health plan Board certification operations. Oversees Direct patient care medical coordination experience required for effective Substantial experience utilization and quality and expertise in the management of the health development of medical plan network. Functions policies, procedures and as medical leadership for programs effective care integration Demonstrated success of pharmacy operations, implementing utilization utilization, case, and and quality improvement disease management strategies and experience activities, quality with physician behavior management activities, modification and provider relations functions. Vice President, Field Accountable for quality Degree in 10 Des Moines, Bachelor’s Health Services improvement, utilization Nursing IA management, pharmacy Unrestricted and current behavioral health, license in Iowa care, and care Managed care experience coordination functions. Experience with Responsible for oversight leadership and and direction of WellCare management , preferably of day-to-day Iowa’s in a managed care activity related to clinical environment care coordination for our Demonstrated expertise members. in Health Services, such as prior authorization, intake, concurrent review, case management, discharge planning including development and management of government programs
Medical Director Responsible for clinical direction of medical services and quality improvement functions at the health plan. Provides medical management leadership and, as applicable, manages all major clinical and quality program components under health plan operations. Oversees medical coordination required for effective utilization and quality management of the health plan network. Functions as medical leadership for effective care integration of pharmacy operations, utilization, case, and disease management activities, quality management activities, and provider relations functions. Doctor of Medicine (MD) or D.O. from an accredited school of medicine recognized by national medical regulatory bodies in the United States An unrestricted and current license to practice medicine in Iowa Board certification Direct patient care experience Substantial experience and expertise in the development of medical policies, procedures and programs Demonstrated success implementing utilization and quality improvement strategies and experience with physician behavior modification 5 Des Moines, IA Vice President, Field Health Services Accountable for quality improvement, utilization management, pharmacy behavioral health, care, and care coordination functions. Responsible for oversight and direction of WellCare of Iowa’s day-to-day activity related to clinical care coordination for our members. Bachelor’s Degree in Nursing Unrestricted and current license in Iowa Managed care experience Experience with leadership and management , preferably in a managed care environment Demonstrated expertise in Health Services, such as prior authorization, intake, concurrent review, case management, discharge planning including development and management of government programs 10 Des Moines, IA
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