Health & Medical Job Description

Health & Medical Job Description

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Health & medical provides behavioral health care case management for Wyoming Medicaid clients as part of larger multi-disciplinary team service delivery model.

Health & Medical Duties & Responsibilities

To write an effective health & medical job description, begin by listing detailed duties, responsibilities and expectations. We have included health & medical job description templates that you can modify and use.

Sample responsibilities for this position include:

Prepare engagement letter for approval by partner
Evaluate work programs prepared by staff
Manage and adhere to engagement time budgets
Supervise staff and provide on-the-job training
Ensure that financial statements, tax returns, and letters of recommendations are prepared in accordance with professional and firm standards
Work to develop responsible, trained staff by assisting in performance evaluations
Prepare invoicing information for client billings, and assist in collection of overdue accounts
Possess a complete knowledge of the firm’s philosophy and its opinions on Quality Control and related matters
Maintain knowledge of regulations, and trends in medical group management
Build and maintain solid and credible relationships with the medical community on Valeant’s behalf in both Academic and Community settings, especially in dermatology

Health & Medical Qualifications

Qualifications for a job description may include education, certification, and experience.

Licensing or Certifications for Health & Medical

List any licenses or certifications required by the position: BLS, EKG, CAOHC, NIOSH, URAC, NCQA, ACLS, PFT, CNA, AHA

Education for Health & Medical

Typically a job would require a certain level of education.

Employers hiring for the health & medical job most commonly would prefer for their future employee to have a relevant degree such as Doctorate and Bachelor's Degree in Education, Medical, Medicine, Graduate, Health, Medical Assistant, Associates, Department of Education, Management, Osteopathic Medicine

Skills for Health & Medical

Desired skills for health & medical include:

Computer applications
Copy fax machines
Multi-line telephone system
Printers
Principles of growth and development over the life span
Commercial products
Medicaid and
Current behavioral health concepts
Demonstrabled capabilities in team building and professional collaboration
Healthcare industry management practices

Desired experience for health & medical includes:

Provide support to KOLs regarding products that have a REMS in place
Follow all applicable policies and procedures related to MSLs
Must maintain a professional appearance and courteous manner
The candidate must be an actively practicing physician
Responsible for the oversight and execution of MHS meetings, including stakeholder meetings, vendor meetings and internal departmental metric reviews
Work with cross company operations team members to develop tools and align on process, trackers, and timelines relating to the MHS activities that interface with cross company and functional initiatives

Health & Medical Examples

1

Health & Medical Job Description

Job Description Example
Our innovative and growing company is searching for experienced candidates for the position of health & medical. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for health & medical
  • Serve as the global lead for engagement with Clinicians and Provider Groups on how to treat more patients after fracture, defining our provider strategy across US, Japan and EU markets, including working with External Engagement and our partners to adapt and develop Guidelines and Care Pathways utilizing innovative Channels for interaction
  • Drive Peer to Peer / Multichannel and KOL engagement strategy for implementation by the regions support for payer engagement, provider DSE initiatives, and engagement with commercial and medical field teams to train on solutions
  • Ensure consistent medical communications and delivery of the core Scientific Platform in delivery of Fracture Demands Action initiatives
  • Direct engagement with KOL clinicians, Clinician Panels and feedback
  • Engagement with Clinicians and Provider Groups on Guidelines and Care Pathways and Innovative Care Solutions
  • Engage with field medical teams to train on solutions and support training of key clinicians, nurses and staff
  • Develop regional-based solutions for field medical and other customer facing teams, focusing on data provided and consolidated from the patient clinical experience that will optimize organizational efficiency within the regional medical groups
  • Devise and execute training of region PVU and Market Access teams on solutions
  • Collaborate with CHPG to grow and improve CHPG involvement in rural outreach efforts
  • Collaborate with CHN to seek opportunities for expansion in Colorado and western Kansas
Qualifications for health & medical
  • Implement and provide oversight for continuing medical education, peer review, case reviews and other educational offerings for rural providers
  • Provider medical direction and oversight of clinically oriented Outreach Health programs such as telehealth, specialty clinics and the CenturaConnect Transfer Center
  • Ensure procedure/clinic rooms are stocked, clean and ready for patients
  • Assist provider by facilitating use of technology including EMR (electronic medical records) and Endoworks(electronic imaging)
  • Coordinate clerical patient care activities and/or specialized technical duties unique to the assigned clinic to ensure accurate and expedited patient check-in and discharge
  • Measure and record vital signs (weight, height, blood pressure)
2

Health & Medical Job Description

Job Description Example
Our company is growing rapidly and is looking to fill the role of health & medical. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for health & medical
  • Maintain all patient/employee records
  • Prepare new clinical records and reviews for accuracy, file all incoming documentation, ensure compliance to company procedures
  • Respond to and maintain a log of external information requests, research information and provide copies to the appropriate person, record receipts of signed orders, log/mail physician's orders, track orders and notify the Clinical Manager when signed orders cannot be obtained within policy allotted timeframes
  • Contact vendors to order medical supplies, maintain adequate inventory and distribute requested supplies in an accurate/timely manner
  • Provide backup to data entry on admissions paperwork, enter billing/payroll information and process/forward paperwork to the appropriate processing center
  • Participate in implementing/maintaining operational processes to ensure compliance to company policies, legal requirements and regulatory mandates
  • Knowledgeable of the principles and practices of insurance claims examinations as it relates to timely filings, state specific information, interest calculations
  • Providing medical expertise into indication selection, assessment of current and future treatment strategies, unmet need, target patient population, TPP, CDP, clinical study protocols and related feasibility assessments, clinical study reports and regulatory submission documents and other documents with content of medical relevance
  • Leading design and implementation of patient preference studies in all therapeutic areas
  • Providing training and ongoing input on medical/scientific issues related to the respective therapeutic area
Qualifications for health & medical
  • Medical/Medical License - Maryland is desired
  • Medical/Medical License Pennsylvania is desired
  • Must possess a thorough understanding of the FDA, OIG, HIPPA and other ethical guidelines relevant to the pharmaceutical industry
  • Responsible for clinical oversight of the Risk Adjustment Program
  • Ensure that all procedures are fulfilling legal and regulatory requirements
  • Be accountable for providing medical expertise and leadership into clinical development strategies to allow project teams to successfully deliver the clinical studies aligned with the TPP and Clinical Development Plan
3

Health & Medical Job Description

Job Description Example
Our innovative and growing company is looking to fill the role of health & medical. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for health & medical
  • Provides support for sales training initiatives for current products and drug product launches
  • Provide physician expertise and leadership focused on UM operations specifically inpatient review by working on a day to day basis with UM nurses to review cases that do not meet medical necessity criteria
  • One-to-one collaborative conversations with physicians /providers as needed
  • Provide support to initiatives that target overuse of medical services including meeting with contracted providers when necessary
  • Review member and provider appeals of medical necessity denials to ensure a fair and unbiased review of initial adverse determinations
  • Identify opportunities to improve end to end processes that aim to identify and correct overuse of medical services
  • Review HAP benefit structure to assure compliance with current medical practice, regulatory requirements and comparability with other health plans
  • Design, develop and take accountability for plans to correct overuse when assigned
  • Advises and assists in planning, directing and reporting clinical service activity
  • Will also ensure clinical activities are in compliance with Student Health Services polices, state and federal statutes and other applicable guidelines
Qualifications for health & medical
  • Establish and maintain a network of KOLs with expertise in running clinical studies in the therapeutic area of interest focusing on Phase 2, 3 and patient preference studies
  • Establish and oversee appropriate Medical Monitoring concepts and integrate preference study methodology into the drug development strategy
  • Experience in the pharmaceutical industry, CRO with significant clinical development experience in Phase 2 and 3 studies and health outcomes related studies
  • Board Certified/Board Eligible in Psychiatric
  • Ability to function as a team member independently to complete responsibilities
  • MD with 2-5 years of experience in the pharmaceutical industry, with preference in clinical development
4

Health & Medical Job Description

Job Description Example
Our company is growing rapidly and is looking for a health & medical. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for health & medical
  • Experience in college health and performing minor office procedures (e.g., suturing, wart removal, I&D, ), ability to diagnose and treat health problems and the ability to communicate both professionally and efficiently in verbal and written communication is essential for success in this position
  • Acts as first contact for Club and Intramural injuries, employee work related injuries
  • Supervises and provides consultations for mid-level providers such as Advanced Registered Practice Nurse (ARNPs) and Physician Assistants (PAs)
  • Ensures the quality of professional standards at levels required by licensing agencies and as outlined by the American College Health Association
  • Oversee the clinical delivery of occupational health services to ensure the corporate goals of service, employee engagement, and patient experience are accomplished and maintain a culture that focuses on quality medical care and customer service
  • Ensure the use of standardized and consistent Occupational Health medical procedures/processes within the QuadMed Health Centers
  • Leadership of CQI in evaluating effectiveness of existing clinical methods and procedures , utilizing data to move quality for patients and value for clients
  • Provide utilization review of occupational health medical charts, including patients seen by primary care provider staff, partnering with the QM quality team
  • Successful completion of in-services and competencies for site specific tasks
  • Manages patient flow with proper check in, rooming processes, communication with health care team and patient/family through the discharge process
Qualifications for health & medical
  • Outstanding writing, good communication and interpersonal skills
  • Experience in medical reception and customer service preferred
  • Unrestricted license to practice medicine in the State of New York and board certified in Psychiatry
  • Minimum five (5) years direct patient clinical experience, minimum seven (7) years of relevant experience in a behavioral health managed care setting - utilization review, quality assurance and/or peer review required
  • Member in good standing of the medical community, Western New York required
  • Demonstrated ability to analyze, interpret and communicate significance of health care data
5

Health & Medical Job Description

Job Description Example
Our company is hiring for a health & medical. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for health & medical
  • Monitor behavioral healthcare utilization authorization and claims data for all behavioral health services
  • Oversee, monitor, and assist with the management of psychopharmacology pharmacy benefit manager (PBM) activities, including the establishment of prior authorization clinical appropriateness of use, and step therapy requirements for the use of stimulants and antipsychotics for all enrolled members under age 18
  • Develop targeted education and training for and provide clinical guidance to contracted primary care physicians (PCPs) treating behavior health-related concerns not requiring referral to behavior health specialists
  • Oversee, monitor and assist with effective strategy and implementation of the Quality Management (QM) program Behavioral Health goals and strategies
  • Share responsibility to manage the behavioral health services delivery system with the Behavioral Health Integration Director
  • Assures that organization behavioral health policies and procedures adhere to contractual obligations
  • Perform clinical case reviews in conjunction with Clinical and Quality Departments
  • Assist providers in exam rooms
  • Escort patients to exam rooms, interview patients, measure vital signs, including weight, blood pressure, pulse, temperature and document all information in patient’s chart
  • Maintain medical records in accordance with established guidelines
Qualifications for health & medical
  • Must have solid understanding of legal and regulatory guidelines
  • Progressive experience in pharmaceutical industry, biotechnology company in medical affairs function
  • Minimum 3 years’ therapeutic area relevant experience required
  • Minimum 5 years work experience within the pharmaceutical/biotech industry
  • Minimum of five (5) years of clinical practice beyond post-graduate training
  • Minimum of three (3) years relevant management experience in health care organizations, preferably relating to managed care

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