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Medical Director - Clinical Policy and Efficacy

GEHA | Lees Summit, Missouri 64086

Salary Range: Call for details
Date Posted: August 15, 2019
Opportunity Code: 18390

Summary

Exciting new physician leadership opportunity with a health plan that provides an unusually high level of a touch and compassion for their members. Government Employee Health Association is one of the largest national medical and dental plan providers for federal employees based in the greater Kansas City, Missouri Metro Area


The Position

  • The Medical Director – Clinical Policy and Efficacy provides medical expertise in the planning and administration of the company’s medical policies and programs
  • Analyzes available medical data and industry benchmarks to inform the development of solutions to improve health outcomes, reduce medical costs and ensure that efficient utilization management processes are implemented
  • Leads efforts to ensure consistent application of existing medical policy, based on evidence-based guidelines
  • Focuses on continuing the culture evolution, supporting the advancement of population health and ensuring appropriate Utilization Management activity
  • The successful candidate must have a strong understanding of clinical processes and how it affects clinical policy
  • Requires a Doctorate of Medicine degree from an accredited institution
  • Active board certification required


The Organization 

  • Government Employee Health Association (GEHA) offers one of the largest national medical and one of the largest national dental plans serving federal employees
  • The organization covers more than 1.8 million federal employees, retirees and their dependents
  • GEHA was one of the first carriers to provide plans to federal employees under the Federal Employees Health Benefits Act of 1959


The Community 

  • Lee’s Summit, Missouri sits in the southeast region of the Kansas City metropolitan area
  • Kansas City is a booming area, known for its barbecue, jazz, heritage, and fountains
  • The city has several distinguished neighborhoods, each with its own rich history, such as: one of America’s largest public farmers’ markets located in the River Market District, the cradle of a distinctive form of jazz in the 18th and Vine District, and the Spanish-styled architecture and upscale shops of the Country Club Plaza
  • Kansas City is also home to Royals baseball, Chiefs football, and Sporting KC soccer



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