Weekend Associate Medical Director – 0.3 FTE

Job Description:

• Assist the CMO with monitoring availability, appropriateness, and necessity of care rendered by participating providers and out-of-plan providers
• Participate in oversight and clinical decision making of the UM program
• Contribute to development of quality care guidelines, internal peer review procedures and evaluation of medical care evaluation studies
• Provide medical consultation for medical/legal issues, member grievance procedures, and development of new benefit packages
• Promote positive relationship between NHP and medical community
• Serve as spokesperson for NHP in the medical community and maintains appropriate contact with professional health care organizations
• Participate in ongoing recruitment of plan physicians
• Assist in development of appropriate medical guidelines and parameters for claims review

Requirements:

• Doctor of Medicine (MD or DO), licensed in the state of Wisconsin without restriction
• Member in good standing of the local medical community
• An active practitioner of medicine in the NHP service areas
• Thorough knowledge of health professional and facilities and standards of practice of medicine in NHP’s service area
• Sufficient medical experience and knowledge of the Medicare program to review organization determinations involving medical necessity
• Board certified in an ABMS medical specialty

Benefits:

• Opportunity to work hard and have fun while getting paid to volunteer in your local neighborhood
• Reliable internet is required for home office work
• Occasional travel required

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