Medical DirectorPrimary Location: Plantation, FL
Additional Locations: FL-Doral, FL-Ft Lauderdale, FL-Orlando, FL-Plantation, FL-Tallahassee, FL-Tampa Apply
Aetna Better Health of Florida is looking for a medical director to join our team. This physician will participate in the development, implementation, and evaluation of clinical/medical programs.
64202Fundamental Components: In this role you will:
Perform daily review of individual cases from concurrent review and prior authorization processes, including denial decisions for cases that do not meet established criteria.
Provide medical review and support for case management and care coordination staff to ensure optimal care is rendered to our members according to the terms of the benefit members receive.
Identify opportunities to implement best practice approaches and introduce innovations to better improve outcomes.
Assess developmental needs and collaborate with others to identify and implement action plans that support the development of high performing teams.
Consistently demonstrate the ability to serve as a model change agent and lead change efforts.
Be responsible for maintaining compliance with policies and procedures and implement them at the employee level.
Reinforce clinical philosophy, programs, policies and procedures.
Evaluate and interpret data, identify areas of improvement, and focus on interventions to improve outcomes. Background Experience: 2-3 years of experience in clinical practice/health care industry.
Previous managed care experience with an insurer/payor highly preferred, but not required Percent of Travel Required: 0 - 10% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer Benefit Eligibility: Benefit eligibility may vary by position. Candidate Privacy Information: Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.
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