Associate Medical Director (Remote - 20 Hours/Week)

Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.

Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes - making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.

Acentra Health is looking for a Associate Medical Director to join our growing team.

Job Summary:

The Associate Medical Director oversees medical activities including peer review, utilization review, higher weighted DRG review (HWDRG), and clinical trend monitoring and analysis. This role reports to the Chief Medical Officer and supports business development and strategic planning.

Responsibilities:

• Oversee day-to-day clinical decision-making aspects of the HWDRG program.
• Collaborate with Clinical Reviewers regarding case determination.
• Discuss complex medical necessity determinations or clinical validation of ICD-10 codes scenarios with Clinical Reviewers.
• Participate in monthly and ad-hoc medical meetings with the client.
• Conduct educational meetings quarterly for Clinical Reviewers.
• Develop and complete monthly and quarterly analyses of HWDRG review trends to make continuous enhancements to the improper payment reduction strategy.
• Perform other assigned duties.
• Adhere to corporate policies, including HIPAA Privacy and Security Rules.

The list of accountabilities is not intended to be all-inclusive and may be expanded to include other education- and experience-related duties that management may deem necessary from time to time.

Required Qualifications

• M.D. or D.O. with a current non-restricted license to practice medicine.
• License must comply with contract requirements.
• Board certification in a clinical specialty.
• Minimum 5 years of active practice (10+ preferred).
• Experience in Utilization Management, Case Management, and/or Clinical Documentation Improvement.

Preferred Qualifications

• Proficient in Microsoft Excel and Microsoft Office applications.
• Excellent written and oral communication skills.
• Professional demeanor with strong collaboration skills.
• Knowledge of quality assurance and utilization review.
• Understanding of healthcare trends.
• Ability to work effectively with diverse personalities.
• Strong organizational and systems-thinking skills.
• Ability to manage projects efficiently.
• Ability to deliver on time and within budget.
• Adaptable, collaborative management style.
• Creative thinker with strong initiative.
• High energy and enthusiasm.
• Ability to adapt to changing work parameters.
• Prior review or quality assurance experience preferred.

Why us?

We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.

We do this through our people.

You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career.

Benefits

Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.

Thank You!

We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search!

~ The Acentra Health Talent Acquisition Team

Visit us at https://careers.acentra.com/jobs

EEO AA M/F/Vet/Disability

Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law.

Compensation

The pay range for this position is listed below.

"Based on our compensation philosophy, an applicant's position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level."