Medical Director

At International SOS, we are in the business of protecting and saving lives. For 40 years, we have delivered customised security risk management, health, and wellbeing solutions to organisations worldwide. With a presence in 90 countries and a team of nearly 13,000 experts, we provide 24/7 support to help organisations fulfil their Duty of Care responsibilities.

Now, we’re looking for talented individuals to join our team and make a difference.

Based in the San Antonio, TX, Regional Contact Centre (RCC), the TOP Medical Director – LAC RCC is responsible for and provides clear leadership in the delivery of professional, quality and effective medical assistance and managed care services to beneficiaries of the TRICARE Overseas Program (TOP) to the highest standards across the Latin America-Canada region (and other locations as directed). This is a full-time in person role located in San Antonio, TX.

The hours are 8 am until 5 pm Monday to Friday (on‑call until 8 pm during weekday evenings).

• Ensure that the operational delivery of TOP medical services and patient care across the region coordinated by the medical team meets the appropriate standard of medical quality in accordance with the TOP Clinical Quality Medical Plan (CQMP), DHA service level expectations and Assistance Centre and Medical Transportation Standards.
• Maintain direct oversight of all TRICARE Prime Remote regional clinical operations and all CONUS‑based inpatient mamanment for TOP beneficiaries
• Support RCC “Follow the Sun” principles and practices
• At an operational level, the Medical Director is responsible for delivering quality medical management of cases, medically appropriate case management direction and oversight in accordance with Intl.
  
  SOS quality standards and medical/operational protocols, ensuring a “hands on” medical supervision of cases, namely:
• Take MD escalations from the Medical Team, ranging from routine care through to urgent/emergent cases including inpatient admissions and medical transportation cases
• Provide MD recommendations for all such escalations and clearly document these recommendations in CRM (electronic medical record).
• Chair weekday morning transmission and afternoon hot handover meetings in order to provide medical case direction

• Provide medical case direction in medical transportation cases
• Ensure adherence to the TOP Medical Transportation SOP and checklists, and International SOS Standards in Medical Transportation
• Assist in the achievement contractual KPIs
• Assist in the maintenance and improvement of the TOP Medical Transportation SOP and checklists

• In conjunction with the TOP Clinical Quality team, be responsible for quality assurance in regard to the provision of all TOP medical services delivered by the TOP RCC for the region, including adherence to client quality plan indices (in particular the CQMP), case audit and review service recovery, assessment of near misses, grievances, Potential Quality Incidents (PQIs) and Quality Incidents (QIs).
  
  Undertaking of Corrective Action Plans and a structured implementation of measures to further enhance delivery of services as a result.
• Drive the quality assurance initiatives and processes, serving as the lead for quality assurance standards for the medical team covering TRICARE, with a focus on customer and client satisfaction and tracking of the medical service delivery.
• Review and analyze medical cases escalated for quality review and address any issues accordingly. This includes involvement in periodic medical case reviews, satisfaction surveys/complaints review, TAO quality case quality meetings, utilization review escalations.
• Provide timely feedback and any applicable coaching or remedial training with the CNs
• Provide clinical guidance and oversight related to Provider quality matters through documented grievances potential quality incidents (PQI) or quality incidents (QI) ensuring investigations are conducted based on standard protocols.

• Develop close and constructive working relationship with the Tricare Area Office Medical Director, nurse case…