Director - Clinical Operations

Qlarant

5d

About The Position

Qlarant is a not-for-profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs. We have multiple lines of business including population health, utilization review, managed care organization quality review, and quality assurance for programs serving individuals with developmental disabilities. Qlarant is also a national leader in fighting fraud, waste and abuse for large organizations across the country. In addition, our Foundation provides grant opportunities to those with programs for underserved communities.

Best People, Best Solutions, Best Results

Job Summary:

Ensures the clinical integrity of the organization, products, and services with a particular focus on contract(s) in multiple jurisdictions, including federal and state. Provides administrative and clinical support to assigned project teams.

Requirements

• PhD required
• 15+ years of experience required
• Valid, current, active, and unrestricted clinical physician license and practice as a health professional in a state or territory of the United States

Responsibilities

• Provides clinical information to teams.
• Provides medical review oversight which includes physician peer review activities; criteria development and assessment; correspondence regarding review determination; recruitment, credentialing and training of expert physician reviewers; managing the expert physician advisory network in specific geographic areas; and serving on external committees.
• Interfaces with external organizations including physician specialty groups, hospital associations, medical societies, affiliates contractors, and state and federal agencies.
• Discusses specific clinical issues with attending physicians.
• Leads and/or participates in quality improvement projects as needed.
• Provides clinical input to specific projects as required by the organization or contractors.
• Supports project managers or teams with specific collaborative projects as needed.
• Maintains working knowledge of current quality improvement issues and tools.
• Manages team performance through regular, timely feedback as well as the formal performance review process to ensure delivery of exceptional services and engagement, motivation, and team development.

What This Job Offers

• Job Type: Full-time
• Career Level: Director
• Education Level: Ph.D. or professional degree
• Number of Employees: 101-250 employees