Dec 01, 2024
$222,380 - $422,520 yearly
This position is remote in New Mexico, candidates must be NM licensed and reside in NM. This position supports the clinical vision for the health plan(s) for all lines of business (Medicaid, Medicare and Commercial) and implements and manages programs to support this vision. The Senior Medical Director ensures the delivery of appropriate health care by overseeing the service coordination, utilization management, care/case management, population health/disease management, cost of care, health promotion, quality improvement programs, and the medical action plans for the assigned business unit and/or designated health plans within a national region. Leads parity efforts and maintains parity documentation and updates with updates in clinical and medical management. Ensures the medical policies, clinical guidelines, quality and clinical operations policies of the company are consistently implemented and NCQA and/or URAC compliant. Analyzes utilization, quality, and financial data to...
Magellan Health
Albuquerque, NM, USA
Full time