The Medical Director works with the Associate Chief Medical Officer and Senior Medical Directors, to oversee all aspects of medical care for Lovelace Health Plan members. Accountable for providing oversight of utilization management functions including prior authorization, concurrent review, and appeals and grievance processes. Participates in Quality activities including Credentialing occurring within the Health Plan.
The Medical Director must have:
? Knowledge of HMOs, PPOs, Medicare, Medicaid, and insurance plans.
? Excellent communication skills to interface with providers, staff and management.
? Ability to analyze and interpret data.
? Moderate computer skills for multiple software applications and communication.
