Qualifications
- Recruits, hires, trains, counsels and evaluates both technical and professional staff involved in the delivery of clinical services who perform Quality Management (!M) and Utilization Management, Credentialing/ Re-credentialing/ Process.
- Participate in the overall development and directions of the Clinical Program.
- Implement the Utilization Management Plan and Quality Management Plan through the Chairmanship of both UM and QM Committees.
- On call after hour’s service as well as coordinate with other specialties such as Psychiatry.
- Establish and maintain standards and protocols of medical care practiced by the Physician groups.
- Monitor the practice of medicine and the implementation of managed care processes.
- Promote continuing medical education opportunities for both internal and external clients.
- Review quality of care issues and provides corrective action plans, education, and counseling through the Utilization Management and Quality Management Committees.
- Assure the standards of care provided by contracted and ancillary providers meet organizational and nationally recognized standards of care.
- Develop or evaluate all policies regarding medical practice and clinical issues.
- Participate in the development of innovative case management, high risk assessment, and other activities that improve quality of care and control costs.
- Communicate with regulatory agencies and their representatives and maintain an understanding of NCQA and HEDIS STANDARDS.
- Analyze data sets, utilization reports and physician practice profiling. Provide evaluation and appropriate action to improve provider performance and quality of care.
- Provides evaluation and appropriate action to improve provider performance and quality of care Credentialing/Re-credentialing principles and methods in clinical updates.
- Monitors the Credentialing and Re-Credentialing of all practitioners and reports results to the board of directors for final approval.
- Chair the UM and QM Committee Meetings with a clear commitment to continuity of the working UM and QM process and an orderly communication of clinical information from the UM/QM Committees to both the Board of Directors and the provider network.
- Participates in the evolution and refinement of the Quality improvement process as well as other committees such as Senior Management, Emergency Preparedness.
- Completes special projects as deemed necessary by the CEO.
Required Qualifications:
- M.D. or D.O. degree with a Current California medical license.
- Minimum 5 years experience as a Primary Care Physician.
- Minimum of 5 years experience in a leadership role in a primary care health setting.
- Board certified in Family Practice or Internal Medicine required.
- Excellent and effective written and verbal communication skills
- Excellent leadership skills, demonstrated ability to effectively lead in changing environments.
- Willing and able to work a varied and flexible schedule to accommodate the needs of MCCN and its patients.
- Accept travel assignments to various sites as needed
Additional Information
Full-time status (30+hrs/wk) benefits include: Health, Dental, Vision and Life Insurance. Vacation, Sick, Holiday pay, and all other benefits mandated by law.
Eligible for CME Reimbursement and CME Time off after 1yr of employment, other benefits (inquire within)
To Apply:
Please email your resume/CV and cover letter, to HR Dept email.
MCCN is an Equal Opportunity Employer