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Job Offer: Mountain Health Cooperative (Idaho) & Montana Health Cooperative (Montana):Mountain Health Cooperative (Idaho) & Montana Health Cooperative (Montana)

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Mountain Health Cooperative (Idaho) & Montana Health Cooperative (Montana)

Mountain Health Cooperative (Idaho) & Montana Health Cooperative (Montana)

Details
Published:
February 9, 2018
Job location:
Helena, Montana

income:
Up to 100000.00
Type:
Part Time - practiced
Discipline:
Executive
Required suitable education
MD/DO

 

MHC (a health insurance cooperative) is seeking Two Part-Time Board-certified Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO) to be part of the Executive team! These Part-time opportunities provide oversight and guidance on medical policy development, accreditation, and program management; one function for each state MHC operates in, Idaho and Montana. If you are a medical provider who considers yourself to be a health care insurance expert, or a know-it-all when Information technology comes to the fascinating ACA regulations, then you’re the type we want to visit with. If this either of these opportunities appear to fit your vision for your career path, we would sure like a chance to visit with you!

Career Opportunity: Medical Director (MD) - [Two Part-time are available]
Organization: Mountain Health Cooperative (Idaho) & Montana Health Cooperative (Montana)
Locations: Boise, Idaho & Helena, Montana (MHC headquarters)
Compensation: Highly competitive income, plus a competitive bonus opportunity and benefits package!
To lgain more: Email Ryan at E-Mail: RCallan@aehr.org; Better yet give me a call at (406) 248-6178
Note: connected Employers is leading the recruitment for MHC’s MD candidates


SUMMARY / OBJECTIVE:
This position is responsible for determining and formulating medical policies and to provide overall direction for the organization. This position provides medical expertise and leadership abilities in the development and delivery of managed health strategies activities, that create greater value. Information technology will be critical that the medical director be accomplished in engaging systems of health care delivery (physicians, and hospital systems) to facilitate the alignment of incentives to achieve the Triple Aim for healthcare. This would include collaboration with the provider contracting team to promote risk relationships, and alternative payment methodologies that compensate providers for efficiency and quality rather than volume. Medical leadership abilities and collaboration with the medical staff of the TPA to facilitate member contract enforcement, and through pharmacy and medical benefit management by maximizing value (quality/cost) of care and service, identifying individuals and populations at risk, with an emphasis on health maintenance, wellness, and health status improvement.

STATISTICS ABOUT MHC:
MHC is a Consumer Operated and Oriented Plan (CO-OP) health insurer with Annual Billable Premiums equating to $230 million, insuring over 50,000 lives. MHC’s operating budget is $31 million+. MHC has a total of 26 employees (Helena: 16, Boise: 10).

expertise, expertise AND ABILITIES:
   » expertise of business and management principles involved in strategic planning, resource allocation, human resources modeling, leadership abilities technique, production methods, and coordination of people and resources.
   » expertise of laws, legal codes, court procedures, precedents, government regulations, executive orders, agency rules and the democratic political process.
   » expertise of principles and processes for providing customer and personal services. This includes customer needs assessment, meeting quality standards for services, and evaluation of customer satisfaction.
   » expertise of principles and methods for showing, promoting, and selling products or services. This includes marketing strategy and tactics, product demonstration, sales techniques, and sales control systems.
   » Identifying complex problems and reviewing related information to develop and evaluate options and implement solutions.
   » Highly organized, strong leadership abilities and clinical operations management and strategic planning practice.
   » expertise of the complexities of the health care environment.
   » Strong collaborator who can effectively work across an organization to engage others in planning and execution.
   » Handling complaints, settling disputes, and resolving grievances and conflicts, or otherwise negotiating with others.

SPECIAL WORK Requirements:
   » Member of the Executive Staff and participates in all Executive meetings.
   » Participates in all care management activities with the third-party administrator’s (TPA) medical director and staff, and shared management of one site nurses.
   » Participates in the TPA’s Pharmacy and Therapeutics Committee.
   » Monitor with standardized metrics the medical and pharmacy cost and utilization of MHC by state, product, network, and perform analysis and identify opportunities to reduce cost.
   » Work collaboratively with Provider Contracting to facilitate improve contractual agreements that improve quality and lowers cost, such as alternative payment methodologies, fee schedules, and prospective payment.
   » Acts as the senior physician with oversight of the Quality Committee and participates in the development of cost-effective quality improvement and assures regulatory compliance to remain certified as a Qualified Health Plan, (QHP).

REQUIRED practice & Appropriate qualifications:
   » MD, DO, with board certification in any medical specialty.
   » 15 years of practice in a managed care setting; and proven practice with medical management, medical policy, quality, accreditation, pharmacy and program management.
   » practiced and familiarity with insurance policies and plans, specifically from the payer side of the industry.

NOTES:
2 openings.
Employer will assist with relocation costs.

Additional income Information: Two Part-time functions are available OR One Full-time function. income will be commensurate with function (part-time/full-time) and practice.Highly competitive income, plus a competitive bonus opportunity and benefits package!

Internal Number: MHC-MD_RCallan

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About Mountain Health Cooperative (Idaho) & Montana Health Cooperative (Montana)
MHC is a Consumer Operated and Oriented health insurance Plan offering quality, affordable plans accepted by doctors and hospitals across the two great states of Montana and Idaho. We use the profit we gain to lower prices or provide additional benefits for members. In order to maintain lower premiums, MHC monitors and controls administrative cost for our members. We have survived and grown through the ACA regulation changes and market fluctuations, recently practiced our best year in multiple areas, and are confident about being a reliable insurance provider and mainstay in the region's health care insurance market.

Skills:

Job Category: Other [ View All Other Jobs ]
Language requirements:
Employment type:
Salary: Unspecified
Degree: Unspecified
Experience (year): Unspecified
Job Location:  Helena, Montana
Company Type Employer
Post Date: 02/09/2018 / Viewed 17 times
Contact Information
Company: Mountain Health Cooperative (Idaho) & Montana Health Cooperative (Montana)
Contact Email: RCallan@aehr.org


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