L&I Associate Medical Director (Physician 3)

State of Washington•Multiple Locations Statewide, WA

2d•Hybrid

About The Position

Within Insurance Services, the Office of the Medical Director (OMD) is responsible for L&I’s statewide health policy to ensure that injured and ill workers have access to high quality, evidence-based care and that services paid for by the workers compensation Medical Aid Fund are clinically appropriate and cost effective. This position will provide clinical input that contributes to a wide range of goals and activities – from rendering clinical advice on individual complex claims to developing, interpreting, and applying health policies such as medical treatment guidelines; providing professionally accredited continuing medical education seminars; and participating in public-private collaborations to address statewide, systemic health issues such as variability in delivery, utilization, and cost of services. The Department of Labor & Industries (L&I) is a diverse state agency dedicated to the safety, health, and security of Washington's workers. We help employers meet safety and health standards and inspect workplaces when alerted to hazards. As administrators of the state's workers' compensation system, we are similar to a large insurance company, providing medical and limited wage-replacement coverage to workers who suffer job-related injuries and illness. Our rules and enforcement programs also help ensure workers are paid what they are owed, that children's and teens' work hours are limited, and that consumers are protected from unsound business practices. Insurance Services is the largest division within the agency and administers one of the premier workers’ compensation organizations in the nation serving over 3.8 million employees working for 260,000 employers.

Requirements

Valid State of Washington Medical License.
Board certification in a relevant medical specialty, including but not limited to common Workers’ Compensation disorders, e.g. Occupational Medicine, Internal Medicine, Rehabilitation Medicine, or Orthopedic Medicine.
Five (5) years’ practice experience post-residency.
Three (3) years of experience in health care leadership, e.g. institutional, professional society, state or county medical society.
Excellent verbal and written communication skills, especially with professional colleagues; skilled in developing respectful, trusting collaborative relationships, and actively resolving conflict.
The ability to take action to learn and grow.
The ability to take action to meet the needs of others.

Nice To Haves

Master’s degree in Public Health or related public health field such as epidemiology, health administration, or health services research.
Juris Doctor degree

Responsibilities

Provide clinical expertise and direct claims support to improve and promote the quality of care received by injured and ill workers.
Receive and respond to referrals by conducting claim reviews, team conferences, and staffing, including direct communication with claims managers, Occupational Nursing Consultants (ONC), injured workers, medical providers, and attorneys.
Provide clinical consultation and recommendations to strategically resolve complex cases, including convening and collaborating with multiple parties on treatment plans and, when appropriate depending on compelling clinical evidence, recommending alternatives to medical treatment guidelines, OMD coverage decisions, agency policy, and HTCC coverage determinations.
Provide clinical expertise and leadership for health policy analysis and development, and program implementation.
Address claims that are leading to increased time loss and poor health outcomes in the workers’ compensation population.
Collaborate on development of evidence-based policies and guidelines.
Coordinate and consult on the formulation and implementation of health care law, rules, policies.
Provide clinical leadership and assistance to collaborative efforts with WA state agencies, and other public and private health organizations.