Medical Director Job Description
Medical director
provides interpretive analyses of complex regulatory guidance documents, regulations, or directives that impact AbbVie’s products and operations.
Medical Director Duties & Responsibilities
To write an effective medical director job description, begin by listing detailed duties, responsibilities and expectations. We have included medical director job description templates that you can modify and use.
Sample responsibilities for this position include:
Good standing with federal and state health care benefits programs, including Medicare, Medicaid and Federal Employee Health Benefits Program
Responding to requests for medical consultations from quality assurance/regulatory affairs
Monitoring studies to ensure compliance with protocol and integrity of data, analyzing results and reviewing medical section of regulatory submissions
Support and assist the Chief Medical Director, fellow Medical Directors and Nurse Consultants
Support Underwriting leadership and Chief Underwriters
Support Underwriting Research and Policy leadership and senior management
Support Underwriting and Claims staffs
Consult as required on cases involving complex medical conditions
Review and recommend underwriting action on cases of $2 mil or greater
Review and interpret cardiac and other medical tests and procedures
Medical Director Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Medical Director
List any licenses or certifications required by the position: CPR, URAC, NCQA, ACLS, BLS, DEA, M.D, CA, ISO
Education for Medical Director
Typically a job would require a certain level of education.
Employers hiring for the medical director job most commonly would prefer for their future employee to have a relevant degree such as Doctorate and University Degree in Medical, Medicine, Medical School, Graduate, Education, Management, Internal Medicine, Psychiatry, Technical, Public Health
Skills for Medical Director
Desired skills for medical director include:
Clinical trial methodology
Commercial products
Compliance and regulatory requirements
Markets
AbbVie’s customers
GCP
Medicaid and
Regulatory
Business operations
Emerging issues
Desired experience for medical director includes:
Monday thru Friday schedule 8a-5p
Operational knowledge of the application of utilization review criteria and guidelines
Medical Doctor or Doctor of Osteopathy, board certified preferable in a primary care specialty (Internal Medicine, Family Practice, Pediatrics or Emergency Medicine)
Educates peer physicians and care managers about utilization management policies and procedures
Is available 24/7 for consultation and peer review as needed
Current board certification in an ABMS or AOA recognized specialty (grandfathered by the board or maintained by the MOC program)
Medical Director Examples
1
Medical Director Job Description
Job Description Example
Our company is looking for a medical director. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for medical director
- Review and/or sign off of protocols, SAPs, clinical study reports, IBs, IMPD and other documents developed for submission to regulatory authorities
- Lead data analysis and writing of regulatory submission documents, for license application and variation activities and for safety issues and questions from regulators
- Defines mission and strategy with CSVP
- Provide daily utilization oversight and external communication with network physicians and hospitals
- Responsible for daily UM reviews – authorizations and denial reviews
- Conducts provider telephonic review and discussion, schedules on-site visits, shares tools, information and guidelines as they relate to cost-effective healthcare delivery and quality of care
- Collaborate with Client Services Team to ensure coordinated approach to delivery system providers
- Contribute to development of action plans and programs to implement strategic initiatives and tactics to address areas of concern and monitor progress toward goals
- Interact, communicate and collaborate with network and community physicians, hospital leaders and other vendors regarding care and services for enrollees
- Provide leadership and guidance to maximize cost management through close coordination with all network and provider contracting
Qualifications for medical director
- Ensure appropriate management/resolution of local queries regarding patient case management either by responding directly or routing these inquiries to the appropriate SME
- Medical Advisory Board participation
- Knowledge of drug development process and oversight of clinical trials
- Promotes the use of evidence based medicine to improve care and outcomes for claimants
- Develops programs and systems to control the use of opioids in claimant treatment, to ensure appropriate use of these medications and to achieve the best health outcomes for claimants
- Serves as the technical lead for NYSIF’s nursing staff of more than 60 employees
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Medical Director Job Description
Job Description Example
Our company is looking for a medical director. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for medical director
- Acts as medical support for NYSIF’s strategic decisions
- Additional comments regarding the vacancy
- Development of medical policies
- Oversight , training and mentoring of Associate Medical Director and Medical Policy Project Managers
- Integration of medical policy with TEC assessment process and principles
- Works to achieve desirable outcomes for customers on service, quality and cost
- Perform initial determinations, appeals, grievances, peer to peer, pharmacy and other reviews, as assigned
- Ensure that all aspects of the medical management process are consistent with community standards of care
- Present data analysis to a wide range of audiences
- Implement action plans designed to achieve and enhance compliance to accreditation standards in accordance with NCQA, URAC, CMS, DOH, and DOL regulations
Qualifications for medical director
- Experience of international health care desired but not essential
- 3-5 years experience in the health care delivery system , clinical practice and health care industry
- 2-3 years of experience in Health Care Delivery System , Clinical Practice and Health Care Industry
- Identify, develop and implement projects that align with the company’s strategic goals
- Provide leadership, direction and drive projects
- Work with existing or potential vendors
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Medical Director Job Description
Job Description Example
Our company is looking for a medical director. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for medical director
- Assists in the development and implementation of medical policy, including recommendations for modifications to enhance efficiency and effectiveness
- Assures compliance with medical policy
- Directs the efforts of the utilization review, case management, and pre-certification functions to accomplish objectives within policy and budget
- Performs daily medical reviews
- Oversees the quality management function in the identification and analysis of medical information to develop interventions to improve quality of care and outcomes and ensure proper provision for participants
- Integration of medical policy with Evidence Street assessment process and principles
- Review of safety data and participate in dose escalation decisions
- Direct the setup of safety procedures and development of safety exchange agreements for co-development projects
- Directs the medical policy for a single-market health plan
- Establishes and implements policies and standards, evaluates new treatments, and evaluates available data sources to ensure the quality of the medical care provided to members for single-market health plan
Qualifications for medical director
- Basic knowledge of HEOR related activities is desirable as well
- Minimum of 5 years practice experience preferred
- Prior experience as a medical director preferred in either a group practice, hospital or health plan
- Strong leadership, communication, written and negotiation skills required
- A Doctor in Medicine (MD) or D.O
- Past participation in a managed care UM committee is preferred
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Medical Director Job Description
Job Description Example
Our company is growing rapidly and is looking to fill the role of medical director. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for medical director
- Develops and maintains partnerships across departments within the division
- Responsible for successfully managing a high member to medical director ratio
- Accountable for supporting the SMD in the development, implementation and execution of the Medical Affairs Strategy and plan for pipeline and in market products
- Participates in the development of Life Cycle Management Plans
- Partners with KOLs to provide insights on current focused therapeutic area issues and questions
- Responsible for setting-up and lead Steering Committee meetings and advisory boards
- Provides input and contribute to the global Therapeutic Area strategic imperatives, Medical Affairs objectives and tactics
- Internal (mainly marketing and sales functions) and external presentations (local advisory board meetings, launch symposia and others) to enhance the medical knowledge of development projects and marketed products
- Ensures that marketing functions have appropriate medical scientific support
- Reviews promotional materials in the respective area according to the company SOP
Qualifications for medical director
- Clear understanding of the managed care field and managed care operating components, with emphasis on clinical management of health services, particularly within an integrated managed care model
- Intermediate proficiency in Microsoft Outlook, Word, Excel, PowerPoint, and Visio
- Active unrestricted New York license to practice medicine or the ability to get one is required
- 5+ years of medical management and general management experience in a managed care environment is preferred
- Primary care discipline, prior experience as Associate Medical Director (or equivalent) or physician reviewer in a Managed Care Plan preferred
- Must be licensed to practice in the state(s) assigned as a medical director/doctor and recognized by the proper licensing authority
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Medical Director Job Description
Job Description Example
Our growing company is looking to fill the role of medical director. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for medical director
- Work closely with project team in the Provincial Office to implement project and achieve project goals
- Provide coaching, mentoring and develop technical capacity in provincial and national programs and technical staff
- Ensure that the activities are technically sound, evidence-based and responsive to the project needs
- Assist in the identification and dissemination of best practices and new technical strategies and approaches
- Develop productive working relationships with counterparts in other agencies and organizations
- Participate in Technical Working Groups in MISAU, CDC and USAID
- Participate in the development of project annual work plans and semi-annual reports
- Provide technical input during the development of Project long-term strategies and reporting
- Keep the Technical Director and other project staff informed of successes, challenges and lessons learned in implementing programs in areas of technical expertise
- Identify and disseminate best practices and new technical strategies and approaches in areas of expertise to project team members
Qualifications for medical director
- Ability to be a hands on, adaptable, focused, flexible, data driven, and results-oriented high performer
- Able to organize, prepare, and deliver presentations to groups or in one-on-one settings
- At least two years of administrative experience in a managed care organization
- Experience with product launches and life-cycle management
- Doctor of Medicine or Doctor of Osteopathy from an accredited medical school
- Current, unrestricted license to practice medicine (including DEA license and BLS certification) in the State of California, or ability to obtain by the time of hire