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Senior Medical Director

Location: Philadelphia BHI
Job Code: 1344


  • Accountable for directing the medical management function for a market or region, which involves overseeing utilization review/quality assurance, directing case management, developing medical policies and preferred protocols, and evaluating new technologies and treatments
  • Creates and implements strategic plans
  • Supports Network Operations and acts as a Physician liaison activity in the community
  • May be responsible for directing the medical management function for a single plan, including setting medical policies and preferred protocols; assuring quality of care for plan members; overseeing and/or performing case management and utilization review; evaluating new technologies and treatments; and operating as the senior medical leader for that plan
  • Develops and maintains partnerships across departments within the division
  • Responsible for successfully managing a high member to member director ratio

Minimum Requirements

  • Degree in medicine from an accredited school and is licensed to practice medicine (Doctor of Medicine or Doctor of Osteopathic Medicine)
  • At least five years of clinical experience in a managed care organization
  • Ability to be hands-on, adaptable, focused, flexible, data-driven, results-oriented, and a high performer
  • Good communication skills

Preferred Requirements

  • Proven analytical skills

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