Medical Director

Medical Director Services

  • Assists in the development and implementation of medical policy.
  • Assures compliance with medical policy.
  • Directs the efforts of the utilization review, case management, and pre-certification functions to accomplish objectives within policy and budget.
  • Performs medical reviews.
  • Oversees the quality management function in the identification and analysis of medical information to develop interventions to improve quality of care and outcomes and ensure proper provision for participants.
  • Review of safety data and pharmacology decisions.
  • Establishes and implements policies and standards, evaluates new treatments, and evaluates available data sources to ensure the quality of the medical care provided.
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