Medical Director (Medical Doctor MD)

Intara Talent Solutions

Intara Talent Solutions - Intara Talent Solutions, an IntegrityM Brand

Remote Employee

Intara Talent Solutions is now seeking a Medical Director to lead and provide oversight to the Medical Review Department. The Medical Director will fill a full-time role and will support the Medical Review team in several functional areas including, but not limited to, Clinical Resource, Complex Medical Review, Provider Education, Medical Review Staff Training and Quality Management.

As a Clinical Resource, the Medical Director will be available for any questions where they will provide clarification on the interpretation of medical policy in relation to a specific case the reviewer is working on or as part of unit wide policy clarification during the monthly Medical Review staff meetings. The Medical Director will be utilized as a resource for the review of complex cases by instructing the nurse reviewer on clinical practice protocols. The Medical Director will be involved in provider education in both written and verbal formats.

Requirements

Work Experience:

• Experience practicing medicine for a minimum of three years as a licensed and board-certified doctor of medicine or osteopathy. Prior work experience in the health insurance industry, a utilization review firm, or another health care claims processing organization in a role that involved developing or reviewing coverage or medical necessity policies and guidelines.
• Extensive knowledge of the Medicare and Medicaid programs, particularly the coverage and payment rules, as well as experience related to the specific workload of the individual task order, which may be further defined in the Task Order Statement of Work.
• Public relations experience such as working with physician groups, beneficiary organizations, and/or congressional offices is preferred.

Educational Requirements:

• The Medical Director must be a board-certified Doctor of Medicine in a specialty recognized by the American Board of Medical Specialties.
• The Medical Director must have been board certified for at least 3 years.
• All clinicians employed or retained as consultants must also be currently licensed to practice medicine in at least one U.S. state, territory, or the District of Columbia.

Intara Talent Solutions is an Equal Opportunity Employer and we do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, and gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.