Vice President, Medical Director

This is a fully remote position, open to applicants in United States.

📋 Description

• Act as a medical authority regarding occupational injuries and the management of workers' compensation medical cases.

• Create and uphold evidence-based clinical guidelines for treatment, recovery expectations, return-to-work planning, and managing disability durations.

• Provide medical oversight and consultation for complex, severe, catastrophic, occupational disease, and fatality claims.

• Evaluate treatment plans, surgical recommendations, impairment ratings, causation inquiries, and medical necessity assessments.

• Assist in resolving disputed medical issues and deliver expert clinical opinions.

• Participate in claims staffings, roundtables, and large loss reviews.

• Collaborate with claims leadership to formulate medical management strategies for high-severity losses.

• Assess long-term care projections, life care plans, Medicare Set-Asides, and estimates of future medical exposure.

• Design clinical programs aimed at improving recovery outcomes and minimizing disability durations.

• Advocate for early intervention and ensure safe, sustainable return-to-work results.

• Analyze medical trends and treatment patterns to enhance outcomes and manage medical costs effectively.

• Suggest emerging treatment protocols, pharmaceuticals, medical technologies, and healthcare delivery models.

• Work in conjunction with utilization review, claims management, network management, and bill review partners.

• Assess provider performance and treatment results.

• Aid in developing networks for occupational health, specialty physicians, and catastrophic injury providers.

• Provide consultation on provider identification, recruitment, contracting, credentialing, and monitoring.

• Act as a senior sponsor for strategic medical vendor partnerships.

• Lead and nurture members of the Medical Management team.

• Mentor claims and operational leaders on medical trends, catastrophic injury management, and clinical best practices.

⛳️ Requirements

• Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) is mandatory.

• Board Certification in Occupational Medicine is highly preferred.

• Additional certifications in Physical Medicine & Rehabilitation, Emergency Medicine, Orthopedic Surgery, Neurology, Trauma Surgery, or related specialties are considered beneficial.

• A minimum of 10 years of clinical experience is required.

• At least 7 years should focus on occupational injuries and workers' compensation.

• Extensive experience in managing catastrophic injuries and complex disability cases is essential.

• Proven leadership experience within an insurance carrier, managed care organization, healthcare system, TPA, or a large self-insured employer.

• In-depth knowledge of workers' compensation medical management, catastrophic injury treatment protocols, disability management, return-to-work strategies, impairment ratings, and life care planning.

• Capability to translate intricate medical information into actionable business recommendations.

• Outstanding communication, influencing, analytical, and executive presentation skills.

• Proficiency in defining problems, gathering data, and drawing valid conclusions.

• Ability to read, analyze, and interpret technical data, financial reports, and legal documents.

• Strong communication skills to effectively interact with providers, business community members, clinical staff, and regulatory agencies.

🏝️ Benefits

• Medical, Dental, and Vision Insurance

• Flexible Spending Accounts

• Paid Parental Leave

• Life, AD&D, and Disability Insurance

• 401(k)

• Employee Share Purchase Plan (ESPP)

• Education and Training Reimbursement

• 10 paid Company Holidays

• 2 Personal Days

• 2 Floating Holidays

• Employee Assistance Program (EAP)

• Hybrid work schedule or remote work option

• Ongoing learning and development

• Career advancement opportunities

• Comprehensive benefits package