Job Quick Facts: Specialty: Family Medicine Associate Medical Director Job Type: Locum-to-Perm Facility Location: Dallas, TX Service Setting: Administrative Reason For Coverage: Supplemental Coverage Period: 13 weeks Coverage Type: Clinical only Shift Schedule: Mon-Fri; 8a-5p Core Responsibilities: - Review prior authorization & appeals for medical necessity - Peer-to-peer provider reviews - Clinical oversight for UM, disease management, and quality management - Participates in developing medical policies, clinical guidelines, and coverage rules - Analyze provider performance data - Review provider applications and quality concerns - Assist the Sr. Medical Director in oversight, evaluation, and administration of the clinical aspects of PCHP fraud, waste & abuse programs, and pharmacy coordination. - Participate in regulatory interactions (state/local agencies), managed care committees - Support development & monitoring of annual organizational goals - Assist in evaluating job design, workflows, and processes for improvement - Ability to interpret/understand Texas Medicaid regulations - Demonstrate leadership, communication, and managed-careoriented skills - Application of medical knowledge within operational/business environments Other Info: - Locum-to-perm transition expected - FULLY remote while working in locums, but will transition to a hybrid model once they go perm Travel, lodging, and malpractice insurance covered Requirements: Active TX License (or willingness to obtain) BC in FM Clean Record (highly preferred) Familiarity with Texas Medicaid Regulation
