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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