RiverSpring Health Plans, formerly known as ElderServe Health, is seeking a full time Medical Director. Our programs include a Managed Long Term Care program (MLTC), Fully Integrated Dual Advantage (FIDA) program, Institutional Special Needs Program (I-SNP) and Medicaid Advantage Plus program (MAP). Collectively, RiverSpring Health Plans helps care for 15,000 members. RiverSpring Health empowers patients, residents and members to live forward every day. ElderServe Health, Inc. is looking for a full time Medical Director to join our dynamic team.
The Medical Director works with an interdisciplinary team of administrative and clinical staff who are highly experienced in the care of the frail elderly and disabled individuals to develop care plans and guidelines and assess quality. The Medical Director is responsible for assuring that the medical care provided to members meets current standards of care and is consistent with individual member needs and wishes.
This position is responsible for the quality assurance program. He/she chairs the Quality Assurance Committee, appoints its members and sets the agenda. He/she identifies opportunities for improvement and leads the development of projects to improve health outcomes. He/she chairs the Medical Advisory Committee which suggests and evaluates clinical practice recommendations. He/she is also a member of the Corporate Compliance Committee. The Medical Director develops policies and procedures related to care, develops practice guidelines and describes their appropriate use, assures compliance with state and federal regulatory requirements for medical care, participates in the training and education of staff, and reviews and discusses problematic cases with physicians, nurses, nurse care managers and other providers to change and improve treatment plans.
This position reports to the Executive Vice President of RiverSpring Health Plans. The ideal candidate must possess a current NYS license and registration; MD degree from an accredited medical school; Board Certification (Internal Medicine a plus); familiarity with Medicare and Medicaid regulatory and reporting requirements; experience in a medical/healthcare management capacity, and good verbal and written communication skills.
We offer a competitive salary, comprehensive benefits, and a congenial work environment that is conducive for professional growth. Please apply directly on our career site.