|Location: Washington, District of Columbia
||Date Posted: 4/1/2020
|Job Code: 2020-51022
The Medical Director will be responsible for every aspect of program management. Will supervise the overall function of the program and will act as the primary point of contact between Contractor staff and the COR to assure effective program operation.
Essential Job Duties:
*Establish and maintain a productive relationship and effective communications with all MAXIMUS clients and other stakeholders, advocates and interested parties
*Oversee all contract administrative functions including budget, financial controls and contract compliance
*Responsible for all P&L activities related to the contract and manage all financial activities related to the project, annual budget process, monthly and quarterly forecast and review
*Develop staffing strategy to meet all performance objectives required of the contract; ensures appropriate performance goals and objectives are established for all project functions; monitors achievement of such goals
*Manage all direct report subject matter experts; works closely with functional managers to ensure project delivery and quality
*Provide consultations to the client regarding medical aspects of the review program.
*Provide citations to authorities as necessary
*Lead development of custom quality measures as needed and educate the team on all quality measures as they related to national standards
*Works closely with functional managers to ensure project delivery and quality
*Oversee quality assurance and manage any necessary corrective actions to ensure consistent application of laws, regulations, policies and procedures pertinent to the project
*Be a resource for clinical staff for data abstractions and medical review
*Propose changes in policy and procedure to improve processes and ensure contract compliance
*Perform other special projects not related to a specific case such as process improvement, general medical research, drafting proposal sections, or acting as a liaison for a specific project, when necessary
*May be required to educate providers, client, clinical staff, or clinical reviewers on issues concerning medical review policies and measures
*Utilize electronic and hard copy tools to research issues
*Understand evidence based clinical reviews,
*Demonstrates teamwork and promotes positive company relations.
Education and Experience Requirements:
*A physician with a current, valid, and unrestricted license
*An active member of the clinical staff of one or more hospitals accredited by external accrediting bodies (i.e. TJC or CARF) and/or community standards (i.e. NCQA or NQS)
*Board Certified, with more than 10 years of medical experience
*10+ years of management experience
*Demonstrated skills in managing complex projects involving the evaluation and quality of care across a multi-center healthcare system
*Support multiple small and large projects with high values and high risk
*Develop innovative methodologies, techniques, and criteria for projects
*Advanced knowledge of workflows and project mapping
*Facilitate the tracking and resolution of issues impacting projects
*Experience with the Veteran's Health Administration
*Experience in abstraction-based models preferably in the areas of Mental Health Care (inpatient and outpatient), Prevention, Stroke Care, and Ethics Policy monitoring
*Experience with Healthcare Effectiveness Data and Information Set (HEDIS) used to measure and report on quality and performance
*Experience managing the development and/or validation of quality measures including those applicable to one of more of the following external accrediting bodies: The Joint Commission (TJC), National Committee for Quality Assurance (NCQA), Commission on Accreditation of Rehab Facilities (CARF), and/or National Quality Standard (NQS)
Essential Duties and Responsibilities:
- Direct the development of training materials for nurses and physicians.
- Oversee quality assurance of nurse and physician work product.
- Provide advice and counsel to the client as directed.
- Direct and control the activities of a broad functional area through several department managers within the company.
- Has overall control of planning, staffing, budgeting, managing expense priorities, and recommending and implementing changes to methods.
- Work on complex issues where analysis of situations or data requires an in-depth knowledge of the company.
- Participate in corporate development of methods, techniques and evaluation criteria for projects, programs, and people.
- Ensure budgets and schedules meet corporate requirements.
- Regularly interact with executives and/or major customers.
- Interactions frequently involve special skills, such as negotiating with customers or management or attempting to influence senior level leaders regarding matters of significance to the organization.
- Report to Senior Director or VP level.
A committed and diverse workforce is our most important resource.
MAXIMUS is and Affirmative Action/Equal Opportunity Employer.
MAXIMUS provides equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disabled status.
Position Type: Full-Time Permanent
Years of Experience Required:
|Contact Name: Maximus, Inc.
|Company: Maximus, Inc.