Medical Director

• Oversee the performance and growth of Customer Service, Prescription Processing, Client-specific teams, managing both internal staff and external vendors
• Lead operational excellence across central fill pharmacy networks and courier delivery operations
• Lead your team with Key Performance Indicators (KPIs) to drive business success and increase efficiency while lowering the cost-to-fill on an annual basis
• Manage quality, turnaround time (TAT), and customer satisfaction metrics to ensure FuzeRx remains the preferred infrastructure partner for telehealth and pharma partners
• Establish requirements for capabilities and reporting, collaborating cross-functionally to deliver data-driven insights
• Analyze data to forecast staffing needs based on program performance, optimizing resource allocation across multiple roles
• Lead a large team of managers, supervisors and team members, establishing an environment of positive employee engagement and experience

Director, Rx Clinical Operations

• support care management, quality, utilization management, credentialing, pharmacy, health policy implementation, technology assessment and risk management activities
• Completes care management case review for cases involving medical necessity review
• Completes appeal case review for cases involving medical necessity review
• Partners to establish priorities as appropriate for improving service at the point of care
• Completes quality of care complaint reviews for cases involving clinical aspects or clinical/service aspects
• Participates in rotation to above Committee Participation

Medical Director – Clinical Ops Case Review

• Work within the Medical Affairs organization to identify, establish, and manage collaborative professional relationships with community-based scientific leaders (SLs) and healthcare providers.
• Conduct peer-level scientific discussions and maintain a reliable presence to ensure SLs have a Medical Affairs contact within our company.
• Engage in proactive non-product discussions regarding scientific issues to understand real-world prevention gaps, persistent disparities, and barriers to uptake across various care settings.
• Facilitate appropriate scientific exchange of information with SLs, including integration of scientific knowledge with actionable insights to inform our Company's research, development and strategies.
• Communicate external stakeholder opinions, insights, and feedback on new data, clinical trends, and the evolving HIV treatment and prevention landscape to Medical Affairs HQ teams.
• Represent R&D at scientific meetings and congresses to understand the sentiment of the consumer and contribute to R&D debriefs, insight discussions, and post-congress reports.
• Develop and execute territory plans in alignment with global Virology strategy.
• Support data generation activities when requested by R&D leadership, including our company's Investigator Study Program (MISP).
• Identify potential investigators for participation in phase II-IV clinical development programs and provide scientific support for R&D sponsored trials as needed.
• Demonstrate and maintain in-depth knowledge of the assigned disease and therapeutic area(s) through educational efforts.
• Fully comply with all company policies and applicable laws, regulations, and ethical standards.

Community MSL, Virology (HIV) – Regional Medical Scientific Associate Director

• Provide leadership, strategic direction, and management of an MSL team to support the company’s mission of advancing precision medicine
• Ensure the team is adequately staffed, trained and clear on the expectations of their role in the execution of their medical plan
• Develop and execute strategies to engage with key opinion leaders (KOLs), healthcare professionals, and other stakeholders within their area
• Lead, mentor, and manage a team of MSLs to ensure effective communication and collaboration with healthcare professionals and KOLs
• Develop and implement strategic plans to support the dissemination of scientific information and data related to Tempus’ products and services
• Establish and maintain relationships with KOLs, healthcare professionals, and other stakeholders to support clinical and scientific objectives
• Oversee the development and delivery of scientific presentations, publications, and other educational materials
• Collaborate with cross-functional teams, including clinical development, marketing, and sales, to support product launches and other initiatives
• Monitor and analyze industry trends, competitive intelligence, and scientific advancements to inform strategic planning
• Ensure compliance with all regulatory and legal requirements in the dissemination of scientific information
• Represent Tempus at scientific conferences, meetings, and other events

Associate Director, Medical Science Liaison

• model the highest levels of clinical integrity, knowledge and cross functional thinking and decision making
• transacts Utilization Management (UM) activities (prior authorization and appeals)
• responds to prescriber inquiries related to UM transactions and CVS Health coverage policies
• report to a Senior Medical Director in the Medical Affairs Department
• provide consultative clinical support to Account Management in support of Key Clients as assigned
• complete assigned medication utilization reviews and/or medical necessity appeals for commercial clients, governmental (Medicare/Medicaid) programs and individual client requested coverage determinations or appeals when appropriate
• participate in inter-rater review activities and other quality oversight processes for internal Director UM decisions
• provide oversight of a portion of CVS Health's clinical programs and commercial client program support
• perform special clinical investigations and research as requested by the Senior Medical Director

• Provide clinical leadership for utilization management programs
• Set UM strategy aligned with organizational goals
• Serve as senior clinical advisor to executive leadership on utilization trends
• Oversee the medical policy team
• Lead the Medical Policy and Utilization Management Governance Committees
• Oversee complex and high-risk utilization review cases
• Conduct clinical reviews and peer-to-peer reviews
• Ensure consistent, evidence-based application of clinical guidelines
• Provide clinical expertise to teams conducting coding and payment integrity
• Act as senior clinical UM liaison to network providers
• Build and maintain strong physician relationships
• Lead development and implementation of UM interventions
• Review utilization data for improvement opportunities
• Ensure UM programs meet regulatory requirements
• Conduct and support training of medical directors and UM staff

Senior Medical Director

• Leverage your background in Pain Medicine disciplines to deliver evidence-based medical reviews that support high-quality patient care.
• Collaborate with healthcare providers and stay current on healthcare regulations and industry developments as you review a wide range of cases.
• Start training remotely in a structured environment with support from trainers, mentors, and leadership to set you up for success.
• Complete time-sensitive, specialized evidence-based medical case reviews for medical necessity on EviCore’s case management software.
• Conduct physician consultation (peer-to-peer) calls with referring providers to discuss evidence–based medical necessity and appropriateness of the requested service or treatment.
• Leverage your clinical expertise to recommend alternative services or treatments as necessary.
• Work collaboratively with over 500 EviCore physician colleagues to help ensure patients receive proper care via evidence-based decision making.

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