The Medical Director will serve as an active member of the Medical Management team to develop relationships with system partners and shape strategy for the organization. This individual will work closely with the Chief Medical Officer, other medical directors and Dean Health Plan staff to improve the quality and effectiveness of patient care and services delivered to health plan members. Together they will establish the organization as an excellent provider of health care services.  Emphasis will be placed on the development, implementation and ongoing management of programs to ensure the proper utilization of services.

The Medical Director along with the Chief Medical Officer will be responsible for designing and developing effective care management and related clinical program initiatives. They will be responsible for helping to determine the long-range plans for disease management and will work to design a plan for the organization.

Strong communication skills are essential, as the person will have the opportunity to work with others across the organizational lines, as well as with the network of providers. This is an opportunity to be exposed to all areas of operations and provide solutions that contribute to Dean Health Plan’s growth objectives.

Job Responsibilities:

• Work with the Senior Vice President and Chief Medical Officer to analyze and improve the quality of care and the patterns of care utilization within the DHP network; work to improve the health status of Dean Health Plan’s member population.

• Be a clinical liaison with the Directors of Utilization Management, Clinical Analysis and Reporting, Performance Measurement, and the Director of Quality Improvement and Wellness.

• Serve as an active member of the leadership team to develop physician networks.

• Chair the Medical Peer Review, Utilization Management and Credentials committees; serve on other committees as assigned by the Senior Vice President and Chief Medical Officer.

• Assume responsibilities for some operational issues as deemed appropriate by the Senior Vice President and Chief Medical Officer.

• Project a positive image of the Health Plan in professional relationships with enrollees, coworkers and Health Plan providers.

• Perform additional responsibilities as deemed necessary by the Dean Health Plan Executive Management.

Requirements:

• Doctor of Medicine or Doctor of Osteopathy with an active unrestricted license to practice medicine in the state of Wisconsin.

• Possess full understanding of health care economics and the medical economics of prepaid plans.

• Demonstrate the ability to communicate effectively with the medical community, administration, subordinates and members.

• Previous experience in successfully collaborating with both clinical and administrative personnel within a Health Management Organization where he or she has gained experience as a medical director of utilization and/or quality management.

• Familiarity with Microsoft Office tools.

• Ability to travel.

• Excellent writing and presentation skills.

• Experience in process management or process improvement.

• Working knowledge of payment system and coding fundamentals.

Preferred Skills:

• Master’s degree in administration or related discipline.

The successful candidate will understand and have a commitment to the philosophy, mission, values and vision of Dean Health Plan. This individual will also possess personal and professional integrity, empathy, excellent communication skills and strong business acumen as an experienced health care leader. Solid analytical and decision-making skills, along with considerable tact and diplomacy, are all extremely important. This individual must have a strong chemistry with the medical management team, be adaptable, a life-long learner, passionate about working with physicians, accountable, and a strategic and tactical thinker. This person must be a democratic leader who has strong coaching skills and is adept at maneuvering within a complex culture that has experienced growth.  Specifically, the following skills and attributes are required to be successful in this position:

• Highly collaborative, cross-functional and systematic.

• An extremely organized, disciplined, hands-on and process-oriented leader who is not afraid of digging into details when necessary.

• High-energy, persistent, assertive, data-driven and focused.

• Good at facilitating group goals in a matrix environment.

• Strong people management and leadership skills. Highly effective and active communicator who works well with people at all levels.

• Open leadership style. Actively seeks out and supports collaborative thinking and problem solving with others in the organization.

• Strategic vision and thinking. Ability to position the organization for the future, looking beyond the present situation to conceptualize key trends and identify changing market demands.