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Review Vacancy

Date Posted 07/08/16

Applications Due08/07/16

Vacancy ID31387

AgencyInsurance Fund, State

TitleMedical Director

Occupational CategoryHealth Care, Human/Social Services

Salary GradeNS

Bargaining UnitM/C - Management / Confidential (Unrepresented)

Salary RangeFrom $200000 to $250000 Annually

Employment Type Full-Time

Appointment Type Temporary

Jurisdictional Class Exempt Class

Travel Percentage 0%

Workweek Mon-Fri

Hours Per Week 37.5

Workday

From 8 AM

To 5 PM

Flextime allowed? No

Mandatory overtime? No

Compressed workweek allowed? No

Telecommuting allowed? No

County New York

Street Address 199 Church Street

City New York

StateNY

Zip Code10007

Minimum Qualifications Minimum and Preferred Qualifications:
• Minimum, M.D. or D.O. with Board Certification in a recognized specialty; preferred, Board Certification in Physical Medicine and Rehabilitation;
• Minimum, at least five years of direct patient care experience; preferred, experience/knowledge of workers’ compensation system and treatment; and
• Active and current New York State medical license without encumbrances.

Duties Description Job description: Under the direction of the Executive team, the New York State Insurance Fund Medical Director will oversee the analysis and management of healthcare for claimants, the review of physician treatments and diagnoses, and the management of prescription practices. He/she will also be responsible for the training, mentoring and direction of all claims and nursing staff on medical issues. The ideal candidate would also teach and conduct health services research in collaboration with academic partners. Examples of possible duties are listed below. The priority for this position will be to set up a team that can effectively analyze healthcare treatment and outcomes data for claimants and help advise on how to improve those outcomes. This initial focus will require the director to have familiarity and experience with quantitative analysis and will also require recruiting additional members for the team who have quantitative skills.

Duties include, but are not limited to the following:

• Responsible for all medical issues related to clinical care impacts, inclusive of cost drivers, settlement issues, utilization review management and reserve prediction.
• Promotes the use of evidence based medicine to improve care and outcomes for claimants.
• Develops programs and systems to control the use of opioids in claimant treatment, to ensure appropriate use of these medications and to achieve the best health outcomes for claimants. Opioid abuse is increasing in New York State and NYSIF is developing a proactive strategy to cut down on opioid use which will require medical expertise to support the implementation of that strategy. The Medical Director will review, address and define policies and procedures to ensure appropriate dosage levels.
• Serves as the technical lead for NYSIF’s nursing staff of more than 60 employees;
? Participates in nurse case management review;
? Attends case review round tables;
? Manages utilization review decisions when questions arise; and
? Defines medical policies and protocols.
• Contributes to the decisions for reserves on special cases.
• Reviews high cost issues and directs independent medical examinations of claimants as warranted.
• Directs, develops and participates in the medical education of Claims Services Representatives, Medical Care Representatives and other Department staff to reinforce the understanding of new technologies and applications currently being requested by the medical community. This training will ensure that claims staff is familiar with evidence-based criteria and best practices.
• Acts as NYSIF’s liaison to the medical community.
• Interfaces with clients as a medical expert.
• Promotes sound medical case management to address medical claims issues that have unexpected indemnity losses and/or problematic return-to-work issues. Conferences with case managers to assist in the review of options for care and direction of the case allowing for better management of the cost of the workers’ compensation claim by delivering superior medical outcomes quickly and cost-effectively.
• Acts as medical support for NYSIF’s strategic decisions. Interacts with all senior management in defining economic policies impacting medical decision/quality.

Some positions may require additional credentials or a background check to verify your identity.

Name Peggy Raymond

Telephone 518-437-6176

Fax 518-437-1618

Email Address hr@nysif.com

Address

Street 15 Computer Drive West

City Albany

State NY

Zip Code 12205

 

Notes on ApplyingPlease provide detailed resume with cover letter when responding to this posting.

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