sanabenefits - Sana Benefits - Medical Director, Health Plan
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Requirements
• Skills needed: None stated explicitly in the job posting provided. • Years of experience: None specified; however, a Master's degree is typically required for this role which often implies significant professional experience. • Education: A minimum requirement of a Master’in Medicine or Public Health from an accredited university with 5 years postgraduate training in healthcare management and leadership (Master's Degree). • Certifications: None explicitly mentioned, but typically required for this role would include certification as a Medical Director. • Must-haves: Experience leading multidisciplinary teams is often considered essential; however, it was not stated in the provided job posting.
Responsibilities
• Oversee the development and implementation of medical policies for our health plan members to ensure they receive appropriate care within their coverage benefits. • Collaborate with a team of physicians, nurses, pharmacists, and other specialists in developing treatment guidelines that align with best practices while considering cost efficiency. • Monitor the quality of medical services provided by our network to ensure they meet or exceed industry standards for patient care outcomes. • Analyze data on health plan utilization patterns to identify trends and develop strategies aimed at improving member satisfaction, reducing costs, and enhancing overall service delivery efficiency within a budgetary framework. • Engage in continuous education by attending conferences, workshops, or seminars related to the evolving needs of our health plan members as well as emerging trends in medical care provision that may impact member coverage options. • Serve on committees and task forces focused on improving patient experience within a managed care environment by providing input based on clinical expertise, industry best practices, or feedback from other stakeholders such as members, providers, payers, employers, etc. • Participate in the development of educational materials for our health plan members and their families to promote awareness about preventive care measures that can help reduce overall medical costs while improving quality outcomes within a budgetary framework. • Maintain open lines of communication with other key stakeholders such as physicians, nurses, pharmacists, administrators, and members themselves to ensure alignment on goals related to patient care delivery efficiency, cost containment strategies, or service improvement initiatives within a budgetary framework. • Provide leadership in fostering an organizational culture that prioritizes the wellbeing of our health plan members by advocating for policies aimed at improving accessibility and affordability while maintaining high standards of care quality as part of ongoing efforts to enhance overall member satisfaction within a budgetary framework. • Collaborate with other departments such as marketing, human resources, or finance in developing strategies that promote the growth and sustainability of our health plan organization by aligning goals related to service delivery efficiency, cost containment measures, quality improvement initiatives, member satisfaction enhancement within a budgetary framework. • Participate in ongoing professional development activities such as continuing medical education (CME) courses or certification programs that are relevant to the role of Medical Director for our health plan organization by attending conferences, workshops, seminars, webinars, etc., within a budgetary framework. • Maintain compliance with all applicable laws and regulations related to medical care provision as well as internal policies governing patient privacy rights (e.g., HIPAA
Benefits
• Remote company with a fully distributed team – no return-to-office mandates • Flexible vacation policy (and a culture of using it) • Medical, dental, and vision insurance with 100% company-paid employee coverage • 401(k), FSA, and HSA plans • Paid parental leave • Short and long-term disability, as well as life insurance • Competitive stock options are offered to all employees • Transparent compensation & formal career development programs • Paid one-month sabbatical after 5 years • Stipends for setting up your home office and an ongoing learning budget • Direct positive impact on members’ lives – wait until you see the positive feedback members share every day
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