Quality Medical Director
Ridgeland, MS
State Health Solutions /
Full-Time /
Hybrid
As the Quality Medical Director, you will oversee Telligen's Mississippi Quality Assurance team to ensure the proper provision of program services. You will serve as a clinical liaison for quality management and improvement activities for the FFS and MississippiCAN programs, located at the DOM Central office, and shall work during normal business hours of DOM. The Quality Medical Director shall not be an active Medicaid Provider.
Essential Functions
- Oversee and have accountability for the medical review activities of the organization or assigned contracts.
- Conduct critical peer reviews to ensure the health provided is appropriate and necessary.
- Instruct other physician reviewers on critical reviews and improvement of health care.
- Assist Telligen staff with training physician reviewers regarding their responsibilities and functions.
- Serve as a technical expert on the peer review process.
- Participate in advisory panels as recommended.
- Represent Telligen policies and procedures to medical and non-medical persons.
- Participate in committee meetings representing Telligen.
Requirements
- Current unrestricted MD or DO license in the state of Mississippi
- Current and active, unrestricted United States board certification by the American Board of Medical Specialties or Advisory Board of Osteopathic Medicine.
- Post-graduate experience in direct clinical patient care.
- Experience with Medicaid is highly preferred.
- 3+ years of managing and/or working with Medicaid, government health plans, or authorization programs is required.
- If remote: must be willing to travel regularly to our Jackson Mississippi office.
- We are unable to consider candidates outside of the United States, candidates in the state of California, or those in US Minor outlying islands and territories.
- Minimum of 3 days/week in office.
Who We Are:
Telligen is one of the most respected population health management organizations in the country. We work with state and federal government programs, as well as employers and health plans offering clinical, analytical, and technical expertise.
Over our 50-year history, health care has evolved - and so have we. What hasn't changed is our deep commitment to those we serve. Our success is built on our ability to adapt, respond to client needs and deliver innovative, mission-driven solutions.
Our business is our people and we’re seeking talented individuals who share our passion and are ready to take ownership, make an impact and helth shape the future of health.
Are you Ready?
We’re on a mission to transform lives and economies by improving health.
Ownership: As a 100% employee-owned company, our employee-owners drive our business and share in our success.
Community: We show up - for our clients, our communities and each other. Being a responsible corporate partner is part of who we are.
Ingenuity: We value bold ideas and calculated risks. Innovation thrives when we challenge the status quo and listen to diverse perspectives.
Integrity: We foster a respectful, inclusive, and collaborative environment built on trust and excellence.
Thank you for your interest in Telligen!
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While we use artificial intelligence tools to enhance our initial screening process, all applications are thoroughly reviewed by our human recruitment team to ensure a fair and comprehensive evaluation of each candidate.
Telligen and our affiliates are Equal Opportunity Employers and E-Verify Participants.
Telligen will not provide sponsorship for this position. If you will require sponsorship for work authorization now or in the future, we cannot consider your application at this time. We will not accept 3rd party solicitations from outside staffing firms.
