Medical Director - SelectHealth

Medical Director - SelectHealth

About Us
What does it mean to be a part of Intermountain Healthcare? It means that the quest for clinical excellence is not just a goal, but a given. It means building an environment where physicians and employees can deliver the best in medicine. And it’s realizing each employee or volunteer is vital to the healing process, because we can only achieve the extraordinary together. 

Being a part of Intermountain Healthcare means joining with a world-class team of over 32,000 employees and embarking on a career filled with opportunities, strength, innovation, and fulfillment. Our mission is: excellence in the provision of healthcare services to communities in the Intermountain region.

Our patients deserve the best in medicine, and we deliver.

Job Description

Accountable for the strategic development and administration of SelectHealth’s medical operations.  Interfaces with Intermountain’s delivery system to improve care and cost outcomes while ensuring quality care for SelectHealth members.  Participates in developing and implementing clinical policies, practices, standards and programs that support the achievement of SelectHealth’s and Intermountain Healthcare’s goals, strategies and objectives.  Serves as a key contact for consultation with staff, panel physicians, other providers and plan members regarding medical operations. Assures the clinical integrity and quality of the company’s managed care products with an emphasis on government payers.   Participates in establishing short and long range goals, objectives, and plans and in the development and implementation of company policies and procedures.  Medical Director roles may focus on any combination of job essentials described below.

• Oversees the quality of SelectHealth’s medical care operations and provides high-level consultation, review and medical direction to all Selecthealth departments.  Provides medical consultation in the development and implementation of operational policies and procedures for the accurate and appropriate administration of contracted benefits.  Reviews and approves all medical changes and options for all SelectHealth products and/or health benefits.
• Provides medical management oversight for SelectHealth’s government products icaid or Medicare by direct decision-making in such areas as pre-authorization, concurrent review of hospitalized patients, discharge planning, complex case and chronic care management and credentialing.
• Cultivates and maintains relationships with appropriate state agencies, advocacy groups, and Federal Qualified Health Centers (FQHCs).
• Collaborates across the Intermountain Healthcare system to develop, implement and evaluate clinical programs and processes that meet Intermountain Healthcare’s business objectives and promote clinical quality and service excellence.
• Works with SelectHealth’s Provider Relations leadership in the ongoing development, maintenance and implementation of effective provider panels, physician fee schedules, reimbursement arrangements and incentive programs.
• Works closely and collaboratively with other departments in SelectHealth to optimize SelectHealth’s operational success. 
• Builds and maintains effective relationships with a number of constituencies including employers, plan members, brokers, providers, hospital management and boards, other health care management companies, government and regulatory bodies and others in the community.
• Oversees SelectHealth’s credentialing process including the development of standards, evaluation of provider credentials, advising others and resolving issues with credentialed and non-credentialed providers.  May work with others across Intermountain Healthcare on the credentialing process to ensure appropriate outcomes.
• Participates in corporate strategic planning with other leaders across Intermountain Healthcare and helps facilitate seamless integration of Intermountain Healthcare hospitals, Intermountain Healthcare Medical Group and SelectHealth by maintaining effective cross-divisional and cross-functional decision-making processes and relationships.  

Minimum Requirements

• MD with Board Certification
• Five years of experience in private practice
• Previous management experience
• Experience with financial and medical expense management
• Knowledge of managed care products and processes
• Understanding of the impact of managed care on the market and cost of health care

Physical Requirements

• Hearing/Listening, Motor Coordination, Seeing, Speaking

Preferred Qualifications

• Medicaid experience

Please Note
All positions subject to close without notice
Intermountain Healthcare is an equal opportunity employer M/F/D/V