Independence Blue Cross, LLC
Part Time - Psychiatrist / Medical Director (Finance)
Utilization Management
The physician directly supports Utilization Management and Care Management and other business activities where involvement of a physician is determined to be in the best interest of Independence. The Psychiatrist / Medical Director will be responsible for rendering coverage and payment determinations based on the terms and conditions of the health plans for which Independence serves as claims administrator, and on the terms and conditions of contracts executed between Independence and networks of participating health care providers.
The Medical Director will exercise sound decision making based on a strong knowledge of clinical medicine, the practical realities of the delivery of health care in the state of Pennsylvania, and a thorough understanding of the principles of population health, quality management, patient safety and health insurance. The Medical Director will be expected to effectively collaborate with professional staff, senior leadership, management and associates and with external partners to promote the delivery of costeffective health care across all lines of business.
Required Qualifications and Experience:
We require a Medical Doctor or Doctor of Physology degree from a medical school or medical school recognized by the American Association of Medical Colleges (AAMC), the American Osteopathic Association (AOA), or the World Health Organization (WHO).
Completion of an accredited residency program in a program accredited by the Liaison Committee of Graduate Medical Education (LCGME) or the AOA.
Has an unrestricted and unencumbered Pennsylvania licenses to practice clinical medicine or osteopathic medicine. Ability to successfully complete Independence Blue Cross credentialing process.