The Medical Director will provide leadership to Utilization Management (UM) teams across Christus Health Plans. This leader will perform medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services. Provides medical leadership for utilization management, care management, cost containment, and medical quality improvement activities. This leader will work collaboratively with Utilization Management, Care Management (CM), and Pharmacy Benefits and Services leaders, as well as non-clinical team members to deliver high-quality utilization management services.
Three to five years of experience in a clinical setting – required
One to three years of experience as a UM Medical Director, Physician Advisor, or equivalent – required
One to three years of experience in leadership and/or management roles - preferred
MD or DO degree from an accredited medical school.
Licenses, Registrations or Certifications:
Current and active license to practice clinical medicine in Texas – required.
Current Board Certification in a clinical specialty – required.
Major Job Responsibilities:
Able to work in a highly matrixed environment and comfortable achieving results through influence, collaboration, and positive relationship development.
Excellent facilitation, conflict resolution and interpersonal skills.
Transactional medical necessity reviews.
Excellent verbal and written skills.
Ability to be flexible and adapt to unique site needs.
Comfortable providing in person communication and presentation in front of large groups.
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CHRISTUS HEALTH is an international Catholic, faith-based, not-for-profit health system comprised of almost more than 600 services and facilities, including more than 60 hospitals and long-term care facilities, 350 clinics and outpatient centers, and dozens of other health ministries and ventures. CHRISTUS operates in 6 U.S. states, Colombia, Chile and 6 states in Mexico. To support our health care ministry, CHRISTUS Health employs approximately 45,000 Associates and has more than 15,000 physicians on medical staffs who provide care and support for patients. CHRISTUS Health is listed among the top ten largest Catholic health systems in the United States.