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Director of Clinical Operations
1 week ago
The Senior Medical Director will lead the development and execution of clinical strategies to improve patient outcomes and reduce costs. This role requires strong leadership skills, clinical expertise, and the ability to collaborate with cross-functional teams.
Responsibilities:- Develop and implement clinical policies and procedures to ensure high-quality care and compliance with regulatory requirements.
- Lead a team of medical directors to review and determine medical necessity for claims and pre-authorizations.
- Provide medical expertise to support claims adjudication, underwriting, and contract language interpretation.
- Establish partnerships with healthcare providers to manage care and improve patient outcomes.
PacificSource is an equal opportunity employer and welcomes applications from qualified individuals with diverse backgrounds and experiences.
About PacificSource: PacificSource is a health plan that provides coverage to individuals and families in the Pacific Northwest. We are committed to improving the health and well-being of our members through innovative clinical programs and exceptional customer service.
