Medical Director - AHA
Qualifications and Capabilities:
· Completion of a residency in an American Board of Medical Specialists (ABMS) approved specialty is preferred.
· Current board certification in an ABMS specialty is required if active certification is permitted under the regulations of the individual certifying board.
· Current, unrestricted license to practice medicine in Pennsylvania is required
· Ability to obtain medical licenses in other states as needed is required.
· Good standing with Medicare, Medicaid and Federal DEA programs is required. (NB: Current DEA registration/ certification is not required.)
· Must successfully meet IBC initial credentialing standards and maintain IBC FOC credentialed status
Experience and Required Skills:
· Three or more years’ experience in utilization management is preferred.
· Direct patient care experience following postgraduate education (internship/residency) in the field of specialty training and certification is required.
· Five or more years in active clinical practice are preferred.
· Strong interpersonal, verbal, and written communication skills, especially in terms of conflict resolution.
· Strong written and verbal presentation skills.
· Proficient in the operation of a personal computer
· Strong knowledge of clinical medicine.
· Good clinical judgment
· Familiarity with current PC software suite used by the organization.
· Broad experience in all areas of medical management.
Inclusion and Belonging
At AmeriHealth Administrators, everyone can feel valued, supported, and comfortable to be themselves, and all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. Celebrating and embracing diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.
About Our Company
AmeriHealth Administrators is one of the largest national third-party administrators providing innovative, value-based health benefits programs and outsourcing services for self-funded health plans and other organizations.
The company also provides customized outsourcing services for TPAs and other payers, student health plans, and fully insured products.
AmeriHealth Administrators serves 1 million plan members in all 50 states and processes over 6 million claims annually.
Equal Employment Opportunity
AmeriHealth Administrators is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Agency Disclaimer
All resumes submitted directly to an AmeriHealth Administrators employee from a vendor via email, the Internet or in any other form without a valid written search agreement in place for this position from the Independence Blue Cross Family of Companies Human Resources Department will be deemed the sole property of AmeriHealth Administrators and the Independence Blue Cross Family of Companies. Please note that no fee will be paid in the event the candidate is hired by AmeriHealth Administrators or the Independence Blue Cross Family of Companies as a result of the referral or through means other than our established process.