Common use of Medical Director Clause in Contracts

Medical Director. The Contractor must employ the services of a Medical Director who is an IHCP provider. The Medical Director must be dedicated full-time to the Hoosier Care Connect program. The Medical Director must oversee the development and implementation of the Contractor’s disease management, care management and complex case management programs; oversee the development of the Contractor’s clinical practice guidelines; review any potential quality of care problems; oversee the Contractor’s clinical management program and programs that address special needs populations; oversee health screenings and assessments; serve as the Contractor’s medical professional interface with the Contractor’s healthcare providers; and direct the Quality Management and Utilization Management programs, including, but not limited to, monitoring, corrective actions and other quality management, utilization management or program integrity activities. The Medical Director, in close coordination with other key staff, is responsible for ensuring that the medical management and quality management components of the Contractor’s operations are in compliance with the terms of the Contract. The Medical Director shall attend all FSSA quality meetings, including the Quality Strategy Committee and Subcommittee meetings. If the Medical Director is unable to attend an FSSA quality meeting, the Medical Director shall designate a representative to take his or her place. This representative must report back to the Medical Director on the meeting’s agenda and action items.