Seeking a part-time Medical Director to fill a vacancy in Emeryville, CA. The ideal candidate will hold a M.D. or Osteopathic degree from an accredited medical school. Must be licensed to practice in the State of California and must be board certified in Pediatric primary care and/or possess pediatric specialty training.
Responsibilities of the Medical Director
The medical director will develop and implement best-practice policies and procedures for medical management.
To ensure quality goals are measured, monitored and met in collaboration with health plan requirements.
Supervise UM and credentialing staff functions by maintaining NCQA and ICE Credentialing standards.
Ensure compliance with all State and Federal regulations.
Actively participates in the auditing process of medical management functions and team improvement projects for medical management.
Provide oversight of the appeal and grievance process as required by health plan partners, while maintaining strong working relationships with health plan, and hospital administrators.
Requirements of the Medical Director
M.D. or Osteopathic degree from an accredited medical school
Must be licensed to practice in the State of California
Board Certified in Pediatric primary care and/or pediatric specialty training
Medi-Cal managed care (medical group, IPA or health plan) experience preferred
Clinical teaching experience desirable.
Internal Number: 1001
About Children First Medical Group
Children First Medical Group (CFMG), the premier pediatric IPA in the Bay Area, is seeking a part time Medical Director. We are based in Emeryville, CA and manage over 50,000 Medi-Cal lives under capitation. CFMG physicians provide quality health care for children across Northern California. We work with hundreds of physicians and specialists who provide the best care for children. CFMG is proud to provide health care services through a distinct, special relationship with UCSF Benioff Children’s Hospital Oakland. The network of physicians participating with our individual practice association total approximately 150 primary care physicians and, over 200 specialty physicians. This position will work with practitioners who are Northern California’s finest pediatricians and pediatric specialists.