Regional Medical Director Resume Sample
Ken Stracke
1904 Enrique Forest,
Detroit,
MI
+1 (555) 114 1242
Work Experience
Regional Medical Director
11/2015
-
PRESENT
San Francisco, CA
- Demonstrates the Telecare mission, purpose, values, and beliefs in everyday language and during contact with internal and external stakeholders
- Act as a Key Liaison, working closely with Corporate CMO office and Program leadership for recruitment and retention of medical staff for assigned region
- Participates in recruitment, retention, credentialing, privileging, FPPE and OPPE of medical staff that meet the highest standards of clinical quality and patient satisfaction
- Guarantees adequate prescriber staffing that meets clinical demand for all programs in their region and within budgetary parameters
- Coordinates and schedules additional physician coverage for prolonged vacancies
- Promotes and maintains harmonious and effective relationships and communications within the department and other departments
- Acts as clinical liaison and Telecare spokesperson with outside stakeholders (County, State, licensing, accrediting organizations, member organizations, etc.)
- Accepts responsibility as the chairperson of committees (such as the Quality Assurance Performance Improvement, Utilization Review, and Pharmacy and Therapeutics committees) for assigned region
Associate Regional Medical Director
02/2011
-
06/2015
Los Angeles, CA
- Collaborates with other administrative staff in strategic planning activities with the goal of ensuring ongoing effectiveness of the facility
- Assists in the development of facility policies and procedures
- Ensures that the facilities within their assigned region maintain compliance with all related state, federal, and local licensing regulations and accreditation standards
- Participate in Root Cause Analyses and reviews incident reports as directed. Makes recommendations for risk management and continuous quality improvement
- Establishes and defines standards that ensure safe and therapeutically effective care
- Assesses the quality of care rendered by facilities and medical staff within their assigned region
- Establishes and maintains a comprehensive Quality Assurance, Performance Improvement program within the medical staff; this includes frequent collaboration with other departments, employee education, and a focus on monitoring departmental standards; actively removes barriers to the provision of high quality care
- Committee participation with Medical Directors at the corporate office at discretion of the Chief Medical Officer and/or Chief, Physician Services Organization
Medical Affairs & Regional Medical Director
02/2007
-
09/2010
Chicago, IL
- Understand, integrate and effectively communicate scientific/medical and commercial value of Horizon’s products to the medical community and other key internal and external audiences
- Develop the regional medical strategy to include scientific content, operational capabilities, quality and complilance. Lead and ensure continued alignment with both the OBU Medical Affairs and Medical Functional strategy and initiatives
- Recruit, supervise, develop and coach medical directors at GPS centers across the designated region
- Assure that medical directors actively support GPS initiatives to redesign and transform the clinical model towards value-based care
- Assure that medical directors are actively engaged, effective, and successful in center-based quality and utilization management, regulatory compliance, IT/EHR implementation, and business development
- Work closely with Area Practice Manager and Director of Provider Relations to assure competent and effective staffing of physicians and mid-level providers in area centers
- Actively lead and support inter-disciplinary collaboration within the area to promote team-based care delivery within GPS centers
- Participate as requested in hospital, physician group, payer, vendor, legislative, and community venues in support of the GPS/GHC mission
Education
University of Mount Union
2002 - 2007
Science's Degree in Health
Professional Skills
- Strong clinical skills and knowledge of concurrent review, case management, ambulatory utilization review
- Working experience in occupational health from the total work experience
- Prior health plan experience - specifically as a Regional Medical Director
- Strong knowledge and understanding of legal and regulatory environment and Merck’s policies
- Experience in a scientific, medical or teaching institution
- Clinical experience is required
- Experience in correctional medicine
How to write Regional Medical Director Resume
Regional Medical Director role is responsible for reporting, training, database, recruiting, compensation, research, insurance, travel, events, basic.
To write great resume for regional medical director job, your resume must include:
- Your contact information
- Work experience
- Education
- Skill listing
Contact Information For Regional Medical Director Resume
The section contact information is important in your regional medical director resume. The recruiter has to be able to contact you ASAP if they like to offer you the job. This is why you need to provide your:
- First and last name
- Telephone number
Work Experience in Your Regional Medical Director Resume
The section work experience is an essential part of your regional medical director resume. It’s the one thing the recruiter really cares about and pays the most attention to.
This section, however, is not just a list of your previous regional medical director responsibilities. It's meant to present you as a wholesome candidate by showcasing your relevant accomplishments and should be tailored specifically to the particular regional medical director position you're applying to.
The work experience section should be the detailed summary of your latest 3 or 4 positions.
Representative Regional Medical Director resume experience can include:
- Serving as a knowledgeable resource related to the evolving population health trends, Triple Aim goals, health economics, and the principles of Quality Improvement and Implementation Science
- Provides HCPs and HBPs accurate information about Merck products and clinical science in a balanced and credible manner consistent with the brand strategy, regulatory environment and Merck’s ethical standards
- Communicate about disease burden, vaccine effectiveness, population health, quality improvement and implementation science in a way that's meaningful and relevant to each individual customer and customize discussions and client interactions based on understanding of customer's needs
- Seeks ways to collaborate with HCPs, HBPs and healthcare organizations to improve patient outcomes, vaccination-delivery processes and to establish vaccination as a prevention strategy
- Five years’ experience practicing medicine in a managed care environment. Two years’ experience in medical management, preferably with an IPA
- Strong leadership talents and works well in a distributed team-based environment. Able to present a strong leadership presence to hospitalist teams
Education on a Regional Medical Director Resume
Make sure to make education a priority on your regional medical director resume. If you’ve been working for a few years and have a few solid positions to show, put your education after your regional medical director experience. For example, if you have a Ph.D in Neuroscience and a Master's in the same sphere, just list your Ph.D. Besides the doctorate, Master’s degrees go next, followed by Bachelor’s and finally, Associate’s degree.
Additional details to include:
- School you graduated from
- Major/ minor
- Year of graduation
- Location of school
These are the four additional pieces of information you should mention when listing your education on your resume.
Professional Skills in Regional Medical Director Resume
When listing skills on your regional medical director resume, remember always to be honest about your level of ability. Include the Skills section after experience.
Present the most important skills in your resume, there's a list of typical regional medical director skills:
- Managing a team internally, requiring good people management skills
- An effective and persuasive communicator who is comfortable speaking with all levels of a hospital administration team and medical staff
- Strong leadership presence for support
- Handling multiple activities while the organization is being segregated into the new Corteva Company
- Accomplishing the following
- Working closely with the Human Resources and EH&S departments
List of Typical Experience For a Regional Medical Director Resume
1
Experience For Associate Regional Medical Director Resume
- Strong interpersonal and telephonic communication skills and ability to be decisive and able to articulate reasoning supporting decisions
- Experience and demonstrated ability to lead and manage highly trained medical, scientific and technical professionals
- Working with the LMD, support CQI based on metrics of quality , satisfaction and cost effective care
- Operate principally within a specific geographic focus within the United States (e.g., Central, Midwest)
- Efficient and effective pharmacovigilance (Drug Safety) function for Genentech
2
Experience For Regional Medical Director, Americas Resume
- Efficient and effective Medical Information service to internal and external customers
- Experience with workplace issues, short and long term disability, and workers compensation
- Develops and maintains effective relationships with providers
- Experience within academia (or a combination of afore mentioned)
- Clinical, research, or public-health experience with vaccines
3
Experience For Medical Affairs & Regional Medical Director Resume
- Population Health Management, Health Economic, Quality Improvement experience
- IPA/Medical Group experience with >100,000 enrollees
- Prior clinical work and board certification in Internal Medicine, Family Medicine, Pediatrics, or Emergency Medicine
- Experience in a medical business-related role (e.g., pharmaceuticals, managed care, practice management, clinical
- Experience with physician engagement and alignment to Organizational Mission, Quality Improvement, and Risk Management initiatives
- Problem solving via joint operating committee’s & internal operational meetings
4
Experience For Vaccines Regional Medical Director Resume
- Develops therapy area reviews, product monographs, slide sets, training packages etc. as appropriate to business and customer needs
- Provides administrative support to the CMO, e.g., recruitment, training, new Medical Center start-up, special projects as assigned
- Supervises Physician and other providers including but not limited to, Nurse Practitioners, Physician Assistants and Mental Health Providers
- Drive to or fly to various meetings or client sites, including overnight trips
- Reports activities in compliant database consistent with policy
- Serves as a vaccine, disease, population health, Quality Improvement expert for the internal organization and collaborator with field personnel to support commercial initiatives and improved population health goals
- Provides Merck internal teams with customer and system insights to assist in informing Merck Vaccines strategies on critical issues and facilitate the development of customer-focused tools and communications to support improved vaccination coverage
- Medical Plans that support Affiliate and global goals
- Efficient and effective evidence generation function that optimally integrates the objectives of the Affiliate and global Life Cycle Teams delivered on time and within budget
5
Experience For Pipc Regional Medical Director Resume
- All studies conducted in the Affiliate undertaken in accordance to ICH/GCP standards, Roche SOPs and quality standards, local operating guidelines and local regulatory requirements
- Effective and efficient product access support service through the provision of formulary dossiers, product value dossiers, health economics and outcomes analyses and scientific liaison services to health care payer/provider systems
- Interactions with investigators, KOLs, ethics committees, clinical research networks, patient groups and local Health Authorities that are effective and positive
- Mentors PLP (Physician Leadership Program) participants as assigned for the purpose of preparing them for the next level of responsibility
- HR decisions for USMA staff in alignment with Roche/Genentech practices
- Company matched retirement plan
- Conducts thorough and timely Peer Reviews for Medical Directors and non-physician practitioners
- Identifies candidates with leadership potential from among site physicians/site medical directors,creates development plans and mentors these high potentials
6
Experience For Mid Atlantic Regional Medical Director Resume
- Benefit from competitive compensation, health benefits, professional liability, 401K contributions, WRVU-based productivity bonuses and paid relocation expenses
- Minimal shift requirement usually between four and eight shifts per month, the majority of your time is administrative
- Review medical treatments for complex claims referred by case management nurses, discuss claims management with treating MD where appropriate, advise LM RNs on appropriate action
- Respond to daily Q&As submitted via iCase Manager, and update archived library of Q&As to insure currency
- Review external guidelines for use at LM and modify as appropriate. Develop and update LM guidelines and policies to meet specific needs as identified by National Medical Director
- Ensure medical accuracy and quality by reviewing samples of peer reviews and IMEs provided by outside vendors, reviews performed by other LM medical directors, reviews by UM/CM nurses, and other internal QA activities as required by URAC and other accrediting bodies
7
Experience For Northeast Regional Medical Director Resume
- Assist National Medical Director with oversight/review of clinical content for LM training programs and participate in training of new clinical personnel (MDs, RNs)
- Serve as a medical resource for a variety of activities at LM, including Legal, Public Affairs, Loss Prevention and Sales & Marketing
- Participate in and provide medical advice to LM committees with various missions, and task forces relating to specific issues/problems
- Explore and disseminate significant updates/changes in LM medical policies to claims managers and CM nurses
- With guidance from Global Health & Medical Affairs & MV US Commercial Leadership, and in coordination with the
- Establish relationships with key healthcare institutions, healthcare professionals (HCPs) and appropriate healthcare
- Business professionals (HBP’s) across segments (Integrated Delivery Systems, Pharmacy, Public Sector, Payer,
8
Experience For Regional Medical Director, Namm Resume
- Employer, and academic medical centers, etc) to provide knowledge & expertise in disease, vaccines, and vaccination processes to ensure that Merck is viewed as demonstrating value and better health outcomes to healthcare professionals and their patients across the lifespan (childhood, adolescent and adult)
- Serving as a knowledgeable resource related to the evolving population health trends, Triple Aim goals, health
- Economics, and the principles of Quality Improvement and Implementation Science
- Provides HCPs and HBPs accurate information about Merck products and clinical science in a balanced and credible
- Manner consistent with the brand strategy, regulatory environment and Merck’s ethical standards
- Science in a way that's meaningful and relevant to each individual customer and customize discussions and client
9
Experience For Gulf States Regional Medical Director Resume
- Seeks ways to collaborate with HCPs, HBPs and healthcare organizations to improve patient outcomes, vaccinationdelivery
- Processes and to establish vaccination as a prevention strategy
- Serves as a vaccine, disease, population health, Quality Improvement expert for the internal organization and
- Collaborator with field personnel to support commercial initiatives and improved population health goals
- On critical issues and facilitate the development of customer-focused tools and communications to support improved
- Maintains expertise in basic and clinical science of vaccines and the diseases they prevent, vaccination process, vaccine
- Health economics, population health trends, Triple Aim goals, the principles of Quality Improvement and Implementation
- Science and the business environment of medicine, through study of current literature, conferences, guidelines, and
10
Experience For Puerto Rico Regional Medical Director Resume
- Interactions with Merck and external scientific resources
- Healthcare business professionals and clinical leaders, to provide clinical and scientific knowledge & expertise to key
- Decision makers in managed-care organizations, integrated health systems, medical groups, pharmacies and publicsector
- Healthcare delivery institutions and agencies
- Serves as a medical and scientific resource to Account Executives, Directors of Commercial Operations, and their teams
- Responsible for addressing components of high quality medical care including clinical services such as cost management, utilization review, quality assurance, and medical protocol development from a client population health perspective
List of Typical Skills For a Regional Medical Director Resume
1
Skills For Associate Regional Medical Director Resume
- Communication Skills(Oral and Written)
- Experience in the use of measures of clinical effectiveness and outcomes, and their use in performance improvement
- Effectively reduce observation rates, length of stay, and readmission rates
- Experienced and organized multi-tasking manager
- Excellent location and great community for young families
2
Skills For Regional Medical Director, Americas Resume
- Senior leadership experience
- At least five years previous pharmaceutical industry experience as an Medical Science Liaison (MSL) or other Medical/Clinical Affairs role is required
- Communicate about disease burden, vaccine effectiveness, population health, quality improvement and implementation
- Assures effective and appropriate utilization of the various levels of care in the provider network
- Build a strong health mindset across the NA Corteva company for all functions and locations
3
Skills For Medical Affairs & Regional Medical Director Resume
- Getting new vendors on board
- Dealing with senior management at a regional level
- Understanding of physician practice management and medical information systems is required
- Optimizes the use of Telehealth for Mentoring, providing schedule care, providing TeleHelp services and the use eConsult modules
- State-of-the-art radiation therapy featuring the most advanced technology, including intensity modulated radiation therapy and Novalis radiosurgery
- In addition, they support the operations and client facing teams as clinical leadership /SME for client facing issues as well as people leadership
- Works with Quality Management in designing and evaluating protocols
4
Skills For Vaccines Regional Medical Director Resume
- Provide clinical oversight to the facility medical programs, as defined by the CCS, accrediting and contracting agency
- Provide leadership to the regional development team (including the Development Delivery members)
- Ensure that the regional/country medical needs and practices are taken into account when elaborating global clinical development plans
- Work in a matrix team with other colleagues to ensure that the development teams are proactively identifying contingencies, potential risks and strategies
- When needed, help resolve issues from BSC providers regarding case and disease management, or non-compliance with administrative requirements
- The latest in imaging technology
- Research, consulting, diagnostics and devices)
- Interactions based on understanding of customer's needs
5
Skills For Pipc Regional Medical Director Resume
- Provides Merck internal teams with customer and system insights to assist in informing Merck Vaccines strategies
- Actively participates in professional society meetings and continuing education (CE) to remain current and to identify
- Areas of new and emerging science of importance to Merck
- Develops and maintains relationships with leading healthcare institutions, professional organizations, providers,
- They partner with the CMO on creating vision, and direction on clinic care
- Assist in interviewing Physicians and Mid-Level Providers
- Advises the Regional Director on the development and review of programs, positions, and budgets having an impact on clinical services
- Implements quality management programs and continuing education activities
6
Skills For Mid Atlantic Regional Medical Director Resume
- Works with Provider Relations to enhance the working relationship between Community Care and the providers in its network
- Minimal shift requirement usually between seven and eight clinical shifts per month
- License to practice medicine in the state of employment
- Formal management/leadership training Formal training in CQI or similar (Lean, Six Sigma, etc. Demonstrated ability to meet financial targets by implementing appropriate clinical quality improvement initiatives
- Current Drug Enforcement Agency (DEA) registration Current Cardiopulmonary Resuscitation (CPR)
- Certification Board-certified or board eligible in primary care specialty (family practice, internal medicine, surgery) required
- Supports up to eight group and IPA physician leaders
7
Skills For Northeast Regional Medical Director Resume
- Oversees 14 clinics in the San Gabriel Valley community
- Ensure that the regional/country medical needs and practices (current treatments, standard of care, unmet medical needs) are taken into account when elaborating global clinical development plans
- Work in a matrix team with other colleagues (other clinicians, statisticians, clinical trial and program managers), to ensure that the development teams are proactively identifying contingencies, potential risks and strategies to address future hurdles
- Co-lead in the country and site/investigator selection process
- Co-lead in feasibility assessment at regional and country level, also provide input into the study protocol as it is developed
- Provide medical input in regional/local study documents for submissions (ICF, information letters, etc.) and overall medical advice to the Development Delivery Group
- Take the lead in managing critical issues (which have a time/budget/relationship impact) linked to the investigator and his/her team and if appropriate manages the escalation process
- Support the Development Strategy, Clinical Development Plan and Clinical Protocols. Recommend scope, complexity and size, which influence the budget of all aspects of a program
- Provide medical input in regional/local study documents for submissions
8
Skills For Regional Medical Director, Namm Resume
- Provide clinical input to assist in the evolution of medical management strategy and best practice development. This includes the integration of traditional UM strategies, ACO and other delivery system model interventions which might influence practice patterns using an integrated approach
- Partner with BSC Quality to support Quality Improvement strategy to achieve BSC Quality goals. Achieve BSC Quality Performance Guarantees for designated lines of business
- Partner with network management to develop new methods to incentivize providers using Value Based Pay for Performance and other incentive plans to ensure consistency of messaging and optimization of behavior change in the delivery system
- Participate on the Regional Market Teams to partner with BSC teammates, including utilization management, concurrent review, case management, ACO team, BSC Pharmacy and clinical quality improvement, markets, among others, to achieve regional goals
- For ACO work, the RMD’s are accountable for meeting key targets set by HCQA to achieve annual plan set for total cost of care as delivered by their Accountable Care Organization partners
- Contribute to making Blue Shield of California a Great Place to Work
- Join a growing and financially secure physician-led organization with best-in-class operations and business management
- Enjoy access to the Hartford HealthCare Physician Leadership Institute, an intensive leadership training program designed specifically for physician leaders
- Knowledge of current laws and regulations governing HMOs, capitation, and risk-based
9
Skills For Gulf States Regional Medical Director Resume
- Board certification in primary care or a sub-specialty in a field(s) important to Merck
- Position combines 20% administrative responsibilities with breast-only surgery at an organization fully committed to breast surgery as a discipline and its own specialty, providing care to the entire spectrum of breast patients
- Lead fellowship trained breast surgeons and surgical oncologists
- Current unrestricted license to practice medicine within the State of California
- Physician and hospital payment methodologies
- Knowledge of Medi-Cal and Medicare programs
- Identify healthcare needs of enrolled populations
10
Skills For Puerto Rico Regional Medical Director Resume
- Excellent communication skills; able to read, write, and speak articulately. Able to use established channels of communication and reporting relationships within the organization
- An active Medical License, in good standing, in state(s) within their assigned region
- Previous work in a multinational company business environment, preferably chemical (crop protection) and agriculture
- Board certification internal or family medicine
- Balanced Perseverance and Resilience
- A comprehensive breast health center that features full-service care for breast cancer patients, from diagnosis to treatment to survivorship
- Unrestricted and active Florida or Texas license required
- On call every 4th or 5th weekend (rotational)
- Experience in a medical business-related role (e.g., pharmaceuticals, managed care, practice management, clinical research, consulting, diagnostics and devices)
List of Typical Responsibilities For a Regional Medical Director Resume
1
Responsibilities For Associate Regional Medical Director Resume
- Focus on clinical documentation improvement efforts thereby improving reimbursement rates
- Collaborate with regional operation and account managers to support change management initiatives
- Serve as a leader for the organizations national quality initiatives
- Serve as a champion and SME for CQI, leading in conjunction with the leadership team strategic projects to continuously improve cost, quality, and service for overall clinical operations , utilizing a CQI focus
- Participate in RFP and new client acquisition
- Escalation point for LMD, operations on providers issues
- Serves as a leader for the organization’s national quality initiatives
2
Responsibilities For Regional Medical Director, Americas Resume
- Upon request, assume the role of Oversight Physician to support nurse practitioners and physician assistants as applicable. (See oversight JD for further definition of roles and responsibility)
- Provides analyses and reviews of ViiV products, therapy area and competitor products, making recommendations, which assist in the determination of current and future strategic direction
- Work with market access as required to prepare tailored responses to address payer and access issues
- Ensures the medical information department and field medical group are up-to-date on new products etc by leading training and by giving advice on complex issues
- Prepares and delivers presentations for sales force training programs and briefing sessions, ensuring that complex scientific data and medical concepts are understood and consistent with promotional strategy
- Facilitates internal relationships within the NA Region as well as with external opinion leaders / influencers
3
Responsibilities For Medical Affairs & Regional Medical Director Resume
- Acts as a liaison for Community Care with community physicians, hospital staff, and other professionals and agencies with regard to psychiatric services
- Acts as a physician reviewer for cases referred by care management staff
- Assures the quality of treatment and related services provided by Community Care professional staff, through participation (directly or by designee) in the ongoing quality management and audit processes
- Ensures the quality of clinical care provided to Community Care members
- Focus on quality and utilization from a regional perspective to include UPMC Passavant and UPMC St. Margaret
- Interfaces with physician consultants and provides direction for the physician consultants. Interfaces with the Physical Health MCO's through Medical Director to Medical Director meetings, and sits on appropriate committees of the PH MCOs
- Interfaces with the Counties and DPW as indicated
4
Responsibilities For Vaccines Regional Medical Director Resume
- Meets or exceeds NCQA, URAC or other regulatory standards
- Participates in the appropriate committees of physical health HMO's where applicable, such as a pharmacy and therapeutics committee
- Reviews of complaints and grievances in accordance with Community Care procedures, and to assure prompt response and action at all stages of the complaint and grievance process
- Reviews the medical aspects of cost and utilization reports generated by Medical Management Information System
- Serve as advisor to quality departments from a regional perspective
- Serves as physician advisor for UPMC Passavant McCandless and UPMC Passavant Cranberry and serves as a backup for other business units
- Supports member satisfaction with the care management process
5
Responsibilities For Pipc Regional Medical Director Resume
- Work in tandem with the UPMC Health Plan
- Works closely with the medical directors of physical health HMO's to assure coordination between physical health and behavioral health needs and services
- Implement programs of quality care analysis, peer review, and professional education
- Build a strong NA Corteva health team from the existing DuPont and Dow Agrosciences health teams with the right leadership and occupational health skills to deliver on the strategy; continue the development of the team as a support system for employees to ensure health standards are met and adhered to
- Plans and directs all aspects of an assigned Medical Center and/or multiple Medical Centers
6
Responsibilities For Mid Atlantic Regional Medical Director Resume
- Serves as a clinical advisor to the management and staff of Erickson Advantage
- Obtain and maintain applicable state medical licensure and DEA registration
- Review and monitor applicable treatment guidelines, clinical decision support monographs and tools, clinical policies and procedures and deploying clinical initiatives
- Understand, utilize and monitor Chronic Care Clinics that assure compliance as defined by the CCS, accrediting and contracting agencies
- Attend all weekly scheduled leadership calls as assigned
- Attend Medical Executive Committee meetings as assigned
- Is an advocate of Takeda’s values internally and externally
7
Responsibilities For Northeast Regional Medical Director Resume
- Management and oversight of internal IHS staff and outsourced occupational health
- Implementation, oversight and management of Health Services Delivery
- Ensure agreed objectives and KPIs are met
- Registered Medical Practitioner, Licensed to Work in USA and possess or be able to gain Medical License to work in Michigan
- Post Graduate Qualification in Occupational Medicine / Board Certification Occupational Medicine
- Certified medical review officer
- Promotions of Healthcare
8
Responsibilities For Regional Medical Director, Namm Resume
- Current US licensure
- Medical & Dental
- Oversee regional utilization management and case management for inpatient cases (acute care hospital, LTACH, Acute rehab, SNF) according to the Humana Medicare Model of Care (MMOC) in all cases where Humana retains some or all of Part A risk in the contractual relationship with IPA’s/MG’s. Also use MMOC to manage HMO & POS members who utilize their out-of-network benefits
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