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Silver Crescent Dispensary – Khobar - KSA
Medical Director JOB DESCRIPTION
BASIC FUNCTIONS:
􀂃Provide professional medical direction services, but not limited to, implementing,
maintaining and refining approved quality assurance/utilization management
programs; keep abreast of and ensure compliance with government regulations for
managed care programs.
􀂃Manage the functions of the Quality Assurance/Utilization Review Committees.
􀂃Identify utilization review studies and evaluate adverse trends in hospital utilization,
unusual provider practice patterns, adequacy of benefit/payment components and
comparative differences in utilization trends by healthcare providers.
􀂃Work collaboratively with member services, medical services, provider relations and
the executive director to prepare, deliver and encourage implementation of
recommendations to provider member for actions which would improve utilization.
􀂃Participate in the review and assessment, and provide advice on, complex,
controversial and/or unique claims which are outside the realm of medical policy;
solicit and evaluate advice of outside medical consultants and physicians with respect
to complex or controversial claims or experimental and innovative techniques.
􀂃Provide medical expertise with respect to planning and establishing goals and policies
to improve medical management.
􀂃Participate in provider network development and new market expansion as appropriate;
participate in the review, assessment and negotiation of provider contracts as
appropriate.
􀂃Collaborate with the Executive Director in the development and implementation of
physician education.
􀂃Represent the institution on ad hoc committees as appropriate; interface with the
provider community regarding medical review, utilization review and quality
assurance issues and concerns.
􀂃Participate in network development, contracting, and credentialing in local and regional
markets.
􀂃Perform other related duties incidental to the work described herein.
EDUCATION:
Work requires a Medical degree from an accredited University. Board certification in
primary specialty is also required.
EXPERIENCE & OTHER QUALIFICATIONS: Five years of clinical practice and
experience in the development and management of utilization review and quality
assurance programs OR AN EQUIVALENT COMBINATION OF RELEVANT
EDUCATION AND/OR EXPERIENCE
Al-Thoqba, Badr / Al-Ola Crossing, 20/21 – PO Box 1968, Al-Khobar 31952-
Tel +96638650005 Saudi Arabia
Silver Crescent Dispensary – Khobar - KSA
APPROVAL / SIGNATURES:
Al-Thoqba, Badr / Al-Ola Crossing, 20/21 – PO Box 1968, Al-Khobar 31952-
Tel +96638650005 Saudi Arabia

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Medical director job description

  • 1. Silver Crescent Dispensary – Khobar - KSA Medical Director JOB DESCRIPTION BASIC FUNCTIONS: 􀂃Provide professional medical direction services, but not limited to, implementing, maintaining and refining approved quality assurance/utilization management programs; keep abreast of and ensure compliance with government regulations for managed care programs. 􀂃Manage the functions of the Quality Assurance/Utilization Review Committees. 􀂃Identify utilization review studies and evaluate adverse trends in hospital utilization, unusual provider practice patterns, adequacy of benefit/payment components and comparative differences in utilization trends by healthcare providers. 􀂃Work collaboratively with member services, medical services, provider relations and the executive director to prepare, deliver and encourage implementation of recommendations to provider member for actions which would improve utilization. 􀂃Participate in the review and assessment, and provide advice on, complex, controversial and/or unique claims which are outside the realm of medical policy; solicit and evaluate advice of outside medical consultants and physicians with respect to complex or controversial claims or experimental and innovative techniques. 􀂃Provide medical expertise with respect to planning and establishing goals and policies to improve medical management. 􀂃Participate in provider network development and new market expansion as appropriate; participate in the review, assessment and negotiation of provider contracts as appropriate. 􀂃Collaborate with the Executive Director in the development and implementation of physician education. 􀂃Represent the institution on ad hoc committees as appropriate; interface with the provider community regarding medical review, utilization review and quality assurance issues and concerns. 􀂃Participate in network development, contracting, and credentialing in local and regional markets. 􀂃Perform other related duties incidental to the work described herein. EDUCATION: Work requires a Medical degree from an accredited University. Board certification in primary specialty is also required. EXPERIENCE & OTHER QUALIFICATIONS: Five years of clinical practice and experience in the development and management of utilization review and quality assurance programs OR AN EQUIVALENT COMBINATION OF RELEVANT EDUCATION AND/OR EXPERIENCE Al-Thoqba, Badr / Al-Ola Crossing, 20/21 – PO Box 1968, Al-Khobar 31952- Tel +96638650005 Saudi Arabia
  • 2. Silver Crescent Dispensary – Khobar - KSA APPROVAL / SIGNATURES: Al-Thoqba, Badr / Al-Ola Crossing, 20/21 – PO Box 1968, Al-Khobar 31952- Tel +96638650005 Saudi Arabia