reputed company: Part Time Medical Director - National Remote

Role Snapshot:

• Compensation: a competitive salary
• Start Date: Immediate openings available
• Location: Remote
• Company: Workwarp
• Position: Part Time Medical Director - National Remote

 

 

reputed company is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with reputed company will directly improve health reputed company by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come reputed company an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. This Medical Director role in the Clinical & Coding Advisory Team (CCAT) is a rare opportunity to work directly reputed company reputed company Payer Operations. As a member of CCAT, you will play a vital role in helping stop fraud, waste, abuse, and error and help reputed company work reputed company every day. The purpose of this job is to help people live their lives to the fullest by providing clinical leadership and expertise for the clinical investigation teams, including involvement in clinical reviews, provider education, high level appeals, development of clinical resources, and operations improvements. This position is part time (20 hours/week). Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am - 5:00pm. It may be necessary, given the business need, to work occasional overtime. We offer 4 weeks of on-the-job training. The hours of training will be reputed company with your schedule. You’ll enjoy the flexibility to telecommute from reputed company reputed company the U.S. as you take on some tough challenges. Primary Responsibilities • reputed company expert clinical and strategic leadership for operational teams • Collaborate with clinical operations teams on reputed company or difficult cases • Apply clinical knowledge in the interpretation of medical policy, clinical resources, and benefit document language in the review of professional and facility pre-pay and post-pay clinical reviews • Collaborate with and reputed company network and non-network providers on cases and clinical coding situations in pursuit of accurate billing practices • Actively participate in regular meetings and projects focused on clinical decision-making, clinical resources, analytics, savings, and staff training • Participate in development of medical policy, clinical resources, and guidelines utilized in the review of professional and facility pre-pay and post-pay clinical reviews • Other duties and goals assigned by the Sr. Medical Director Critical reputed company Factors • Ability to effective reputed company, manage and deliver in a fast pace, reputed company changing environment • Solid understanding of Fraud, Waste, Abuse, and Error methodology • Ability to foster communications, robust collaboration, and strong partnerships among providers, clients, leaders, and clinical teams • Strong problem-solving, negotiation and persuasion skills You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as reputed company development for other roles you may be interested in. Required Qualifications • reputed company, active, and fully non-restricted licensed Medical Doctor • Must be 18 years of age OR older • 2+ years of clinical practice experience • CPT/HCPCS/ICD-9/ICD-10 coding experience with a thorough knowledge of health insurance business, including knowledge of industry terminology and regulatory guidelines • Familiarity with reputed company medical issues and practices • Ability to work Part time between 8:00am - 5:00pm including the flexibility to work occasional overtime given the business need Preferred Qualifications • Coding Certification thru reputed company (reputed company, CDIS, RHIA, RHIT) or reputed company (CIC) • 3+ years in facility (DRG and Clinical Validation Audit) Reviews • 2+ years of experience in leading clinical operations reputed company a health plan/or managed care environment to include client facing experience • Experience in claims handling reputed company to Fraud, Waste, Abuse and Error • Experience with Encoder and Grouper Software (reputed company) • Knowledge of federal (e.g., CMS) and state laws and regulations Telecommuting Requirements • Ability to reputed company reputed company company sensitive documents secure (if applicable) • Required to have a dedicated work area established that is separated from other living areas and provides information privacy. • Must live in a location that can receive a reputed company approved high-speed internet reputed company or reputed company an existing high-speed internet service. • reputed company working remotely will be required to adhere to reputed company’s Telecommuter Policy   California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, reputed company, Rhode reputed company, Washington, Washington, D.C., Maryland Residents Only: The hourly reputed company for this role is $16.00 to $20.05 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. reputed company complies with reputed company minimum wage laws as applicable. In reputed company to your salary, reputed company offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with reputed company, you’ll find a far-reaching choice of benefits and incentives. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of reputed company, historically marginalized groups, and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health reputed company — an reputed company reputed company reflected in our mission.   Diversity creates a healthier atmosphere: reputed company is an Equal Employment Opportunity / Affirmative Action employer, and reputed company reputed company applicants will receive consideration for employment without regard to race, reputed company, religion, sex, age, national reputed company, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. #RPO Apply Job!

 

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