Omaha National is seeking a Medical Services Director. This is a rare opportunity to join a young, growing, highly successful company in an important executive position with tremendous opportunity.
The Medical Services Director is a key leadership position that will oversee multiple key operations including Medical Bill Review, Utilization Review, and Medical Networks.
We are looking for a professional with broad, strong knowledge of medicine and the business of medicine and the experience or aptitude to serve as a positive leader. The ideal candidate has experience in multiple roles in a clinic or hospital setting.
This is a rare ground-floor opportunity to join a happy, high-performing team while taking a leading role in growing and managing important business functions. Previous experience in workers compensation is not required: we will provide extensive training in that area. The candidate may be early in career or possess many years of experience; compensation is commensurate with experience
- With the help of a strong, supportive executive leadership team, build and manage our Utilization Review, Medical Bill Review, Medical Networks, and Resource Nurse teams.
- Train, lead, coach, and mentor supervisors and managers to oversee those functions.
- Serve as a role model of our company culture.
- Strongly collaborative, ego-free work style; fit into a culture in which people genuinely enjoy working together.
- Actively foster and sustain open, collaborative partnerships with Claims Adjusting, Special Investigations, and the other departments within the company.
- Engage in extensive, sometimes challenging, communication with medical professionals and others outside the company.
- In workers compensation, Utilization Review reviews requests for authorization of proposed medical treatment of injured workers and is responsible for ensuring the treatment provided is timely, appropriate, and safe.
- Ensure that medical bills are reimbursed for the appropriate amounts.
- Establish, monitor, and continually improve networks and panels of high-quality medical providers to treat injured workers. Serve as Omaha National’s liaison with networks for outbound and inbound communication regarding issues relating to their services and working to resolve those issues.
- Design department policies and procedures that ensure efficient workflows and positive outcomes.
- Analyze data, monitor performance, and continually improve processes and strategies.
- Select and manage contractual relationships with outside vendors to provide certain support services.
- Develop a strong knowledge of applicable regulatory and accreditation requirements.
- The experience or aptitude to serve as an exceptional, positive leader with happy employees producing exceptional work while collaborating with company executives at a strategic level.
- Bachelor’s or advanced degree in a medical field or comparable work experience in the medical industry.
- A strong aptitude for research regarding legal requirements and industry practices, including the ability to understand and apply complex legal, medical, and business documents.
- Strong ability to analyze data, identify trends and exceptions, develop plans and proposals, and exercise sound strategic judgment.
- Experience with traumatic and cumulative injuries, orthopedics, and occupational medicine is helpful but not required.
- Background in areas including, anatomy, physiology, diagnostics, treatment plans, pharmacology, physician specialty, and the business of medicine, and the ability to rapidly gain knowledge to fill in current gaps.
- Ability to rapidly and deeply learn relevant workers’ compensation statutes and regulations.
- Ability to learn and effectively apply, evidence-based medical treatment guidelines such as ODG, ACOEM Guidelines, and MTUS
- Proficient in Microsoft Office programs and a demonstrated ability to master other software applications as needed.
Omaha National provides a safe, stable, positive work environment, competitive pay, excellent benefits, 401K, and paid vacation and sick leave.
Omaha National Group