Institute for Credentialing Excellence (ICE) RWJBarnabas Health
is Seeking a Senior Medical Director of Population Health
RWJBarnabas Health is Seeking a Senior Medical Director of
Population Health RWJBarnabas Health is Seeking a Senior Medical
Director of Population Health
The Senior Medical Director (MD) is responsible for providing
clinical expertise in support of population health and medical
management programs to promote the delivery of high quality,
cost-effective, constituent responsive medical care for the
populations and the networks that we manage. The Senior Medical
Director is a critical medical and business leader participating in
the overall medical and quality management for RWJBH Population
Health, as well as the contact for external providers and related
constituencies. As part of the medical director leadership team,
the Senior MD will partner with the Population Health Care
Management Team and other RWJBH assets to increase the
effectiveness of care management and medical management programs to
promote integration among the RWJBH health and medical programs.
Additionally, the Senior MD focuses on innovative approaches for
improving the quality, efficiency, and appropriateness of care
delivered with an eye toward system-wide value enhancements through
the institution of best practices, technological solutions, or
Collaborates with community and employed physicians, staff, and
constituencies to support their efforts to improve utilization,
quality of care, patients/member experience, medical documentation,
etc. for RWJBH Population Health programs.
Communicates, educates, and develops partnerships with payors
and providers (including medical groups and hospital systems) and
serves, when needed, as the interface between the RWJBH teams and
Execute predetermination reviews, reviews of claim
determinations, providing clinical, coding, and reimbursement
Manage UM transactional work (front line reviews and
Oversee utilization review/quality assurance in collaboration
with case management.
Provide UM services based on business demands and shifting
Partner with care management and medical management leadership
to increase effectiveness of medical management programs and to
promote the integration of other medical programs.
Provide clinical guidance in operating effective medical
programs to promote member and patient quality of care and in
reviewing potential lapses in the quality of care.
Proactively use data analysis to identify opportunities for
quality and clinical improvement, to positively influence the
effective delivery of quality care.
Work collaboratively with other functional areas and RWJBH
assets that interface with medical management
Act as part of the medical ship team for external payors,
providers, and community in general.
Act to engage providers and facilities in improving the quality,
clinical, and cost efficient care delivered to members and
patients, while assuring that our shared business relationships are
maintained and improved.
Graduate of an accredited medical school; Doctorate degree in
Candidates with post-graduate degrees (e.g., MBA, MPH, MMM)
Board certification in an American Board of Medical Specialties
(ABMS) recognized specialty
Active, unrestricted active medical license in New Jersey as a
Doctor of Medicine or a Doctor of Osteopathy
Clinical Practice: 5-10 Years of direct patient care
Administration/Management 2-3 years of experience in Health Care
1-2 years of experience in Clinical leadership (ex. quality
review, peer review, group/practice management, hospital teams)
Medical Management or Care Management 5+ years of
knowledge/experience in managed care (consultant, medical director,
Interacting with Medical Professionals
Driving a Culture of Transformation and Compliance
Collaborating for Results
Please note this job description is not designed to cover or
contain a comprehensive listing of activities, duties or
responsibilities that are required of the employee for this job.
Duties, responsibilities and activities may change at any time with
or without notice.
We offer a great work environment, competitive rates and
excellent benefits, including:
Vacation/Personal/Holiday/Sick Time Off
Short & Long Term Disability
Basic Life & Accidental Death Insurance
Health Care/Dependent Care Flexible Spending Accounts
RWJBarnabas Health is the most comprehensive health care
delivery system in New Jersey and the state’s second largest
private employer – with more than 32,000 employees, 9,000
physicians and 1,000 residents and interns. The system includes
eleven acute care hospitals, three acute care children’s hospitals
and a leading pediatric rehabilitation hospital (Children’s
Position Title: RWJBarnabas Health is Seeking a Senior Medical
Director of Population Health
Please refer to the company's website or job descriptions to
learn more about them.
RWJBarnabas Health is seeking a Hematologist/Oncologist for
Full-Time Employment in Central NJ
Long Branch, New Jersey, United States
30+ days ago
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