Senior Medical Director, Medicaid Virginia

Sentara Health Plans is recruiting a Senior Medical Director- Medicaid!
This is a remote position for a resident of one of the following states:
Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Dakota, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington (state), West Virginia, Wisconsin, Wyoming
The

Senior Medical Director -Medicaid

is responsible for providing clinical leadership within Sentara Health Plans, aligned to one or more plans. Accountable for monitoring utilization, case management and quality outcomes. The

Senior Medical Director collaborates with the Sentara Health Plans Chief Medical Director, Medical Director(s) and Clinical Care Services (CCS) teams to establish, implement, and evaluate effectiveness of clinical programs to support members and meet the department goals. Medical Director activities further include support of the CCS nurses, Government services nurses, Pharmacy staff, Population Health and Quality Improvement Teams. Lastly, Medical Directors interact externally with network physicians, vended program clinical leaders, and government program leaders as required to improve the quality of clinical outcomes, cost efficiency and patient/member experience with the Health Plan and Health Systems with which we contract.
Licensed in the state of health plan coverage and board certification required. Master's level degree in Medical Management, Business Administration or Public Health preferred. Medicaid, including long term services and support, experience preferred
Position Summary

:

Responsible for providing clinical leadership within Sentara Health Plans, aligned to one or more plans. Accountable for monitoring utilization, case management and quality outcomes. The Senior Medical Director collaborates with the Sentara Health Plans Chief Medical Director, Medical Director(s) and Clinical Care Services (CCS) teams to establish, implement, and evaluate effectiveness of clinical programs to support members and meet the department goals. Medical Director activities further include support of the CCS nurses, Government services nurses, Pharmacy staff, Population Health and Quality Improvement Teams. Lastly, Medical Directors interact externally with network physicians, vended program clinical leaders, and government program leaders as required to improve the quality of clinical outcomes, cost efficiency and patient/member experience with the Health Plan and Health Systems with which we contract.
Minimum Requirements:
Licensed in the state of health plan coverage and board certification

Master's level degree

Five years or more of related experience

Preferred:
Medicaid, including long term services and support,

Degree in

Medical Management, Business Administration or Public Health

Sentara Health Plans

is the health insurance division of Sentara Health that provides health insurance coverage through a full suite of commercial products including consumer-driven, employee-owned and employer-sponsored plans, individual and family health plans, employee assistance plans and plans serving Medicare and Medicaid enrollees. With more than 30 years’ experience in the insurance business and 20 years’ experience serving Medicaid populations, we offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services – all to help our members improve their health. Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth.
Diversity and Inclusion at Sentara
Our vision is that everyone brings the strengths that come with diversity to work with them every day. When we are achieving our vision, we have team members that feel they belong and can be their authentic selves, and our workforce is reflective of the communities we serve.
We are realizing this vision through our Diversity and Inclusion strategy, which has three pillars: A diverse and talented workforce, an inclusive and supportive workplace, and outreach and engagement with our community. We have made remarkable strides in these areas over the past several years and, as our world continues to evolve, we know our work is never done.
Our strategies focus on both

structural inclusion

, which looks at our organizational structures, processes, and practices; as well as

behavioral inclusion

, which evaluates our mindsets, skillsets, and relationships. Together, these strategies are moving our organization forward in an environment that fosters a culture of mutual respect and belonging for all.
Sentara Benefits
As the third-largest employer in Virginia, Sentara Health was named by Forbes Magazine as one of America's best large employers.

We offer a variety of amenities to our employees, including, but not limited to:
Medical, Dental, and Vision Insurance

Paid Annual Leave, Sick Leave

Flexible Spending Accounts

Retirement funds with matching contribution

Supplemental insurance policies, including legal, Life Insurance and AD&D among others

Work Perks program including discounted movie and theme park tickets among other great deals

Opportunities for further advancement within our organization

Sentara employees strive to make our communities healthier places to live. We're setting the standard for medical excellence within a vibrant, creative, and highly productive workplace.

For information about our employee benefits, please visit:

Benefits - Sentara (sentaracareers.com)

Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve!
To apply, please go to

www.sentaracareers.com
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Talroo – Health Plan
Managed Care, Health Plan, Healthcare, Medical Director
The Senior Medical Director is responsible for providing clinical leadership within Sentara Health Plans, aligned to one or more plans. Accountable for monitoring utilization, case management and quality outcomes. The

Senior Medical Director collaborates with the Sentara Health Plans Chief Medical Director, Medical Director(s) and Clinical Care Services (CCS) teams to establish, implement, and evaluate effectiveness of clinical programs to support members and meet the department goals. Medical Director activities further include support of the CCS nurses, Government services nurses, Pharmacy staff, Population Health and Quality Improvement Teams. Lastly, Medical Directors interact externally with network physicians, vended program clinical leaders, and government program leaders as required to improve the quality of clinical outcomes, cost efficiency and patient/member experience with the Health Plan and Health Systems with which we contract.

Licensed in the state of health plan coverage and board certification required. Master's level degree in Medical Management, Business Administration or Public Health preferred. Medicaid, including long term services and support, experience preferred

Medical Doctor (MD) - State License - Virginia Department of Health Professionals (VADHP)
Medical Doctor (MD) - Certification - Other/National
Medical Doctor (MD) - Certification - North Carolina
Doctor of Medicine
Project Management Previous Experience
Population Management Previous Experience
Performance Improvement Previous Experience
Clinical Practice 5 years
Microsoft Excel
Quality Control Analysis
Mgmt of Staff Resources
Project Management
Mgmt of Material Resources
Persuasion
Mgmt of Financial Resources
Mathematics
Learning Strategies
Leadership
Judgment and Decision Making
Critical Thinking
Coordination
Complex Problem Solving
Communication
Active Listening
Active Learning
Writing
Troubleshooting
Time Management
Technology/Computer
Systems Evaluation
Systems Analysis
Speaking
Social Perceptiveness
Service Orientation
Monitoring
Science
Microsoft Word
Reading Comprehension

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