Company: Max Populi, LLC
Posted on: June 25, 2022
Join a growing team of medical management professionals at one
of the fastest healthcare companies in the country. - This division
is one of the fastest growing businesses in a company with the
largest and most successful Medicaid business in the nation.
Responsible for the administration of medical management services
for company health plans and ensures clinical integrity of broad
and significant clinical programs, including the overall medical
policies of the Medicare business unit. Primary duties may include,
but are not limited to:
- Evaluates requests for service coverage for medical necessity
- Interprets existing policies and develops new policies based on
changes in the healthcare or medical arena.
- Leads, develops, directs and implements clinical and
non-clinical activities that impact health care quality cost and
- Supports the Medical Management staff ensuring timely and
consistent responses to members and providers.
- Identifies and develops opportunities for innovation to
increase effectiveness and quality.
- Serves as a resource and consultant to other areas of the
- May chair or serve on company committees.
- May be required to represent Anthem -to external entities
and/or serve on external committee Skills
MD or DO in MN
At least 5 years of post-residency clinical experience required
Requires current, unrestricted MN license to practice medicine
Current ABMS recognized board certification required
Internal Medicine, Surgery, Pediatrics or OBYN specialties
Previous UM/appeals experience preferred - Competitive compensation
with benefits offered. Contact information:
Keywords: Max Populi, LLC, Knoxville , Medical Director, Executive , Clairfield, Tennessee
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