Medical Director – Nat'l UM Team

Medical DirectorMedical DirectorFull TimeRemoteTeam 10,001+Since 1961H1B SponsorCompany SiteLinkedIn

Location

United States

Posted

121 days ago

Salary

$223.8K - $313.1K / year

Postgraduate Degree5 yrs expEnglish

Job Description

• The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, level of care, and/or site of service should be authorized. • The Medical Director’s work includes reviewing of all submitted medical records, synthesizing complex hospital-based clinical scenarios, and providing expert decisioning on the requested services. • Conduct comprehensive, timely, and compliant medical necessity reviews for inpatient services • Maintain accountability for productivity, quality, and compliance metrics • Communicate determinations clearly both verbally and in writing • Demonstrate adaptability and willingness to learn evolving workflows, tools, and utilization management practices • Participate in educational activities by attending required conferences and also create content to lead/teach/present for individual subject matter contribution

Job Requirements

  • MD or DO degree
  • 5+ years of direct clinical patient care experience post residency or fellowship, which preferably includes some experience in an inpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age).
  • Current and ongoing Board Certification an approved ABMS Medical Specialty
  • A current and unrestricted license in at least one jurisdiction and willing to obtain additional license, if required.
  • No current sanction from Federal or State Governmental organizations, and able to pass credentialing requirements.
  • Excellent verbal and written communication skills.
  • Evidence of analytic and interpretation skills, with prior experience working in a team environment.

Benefits

  • medical, dental and vision benefits
  • 401(k) retirement savings plan
  • paid time off, including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave
  • short-term and long-term disability
  • life insurance and many other opportunities

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