Remote Inpatient Medicare Medical Director (Medicare)

Location: Remote-MO; remote role based in the United States

Salary: $215,000–$408,500 per year

Company

hirify.global provides healthcare services focused on connecting people with the care they need and improving access, quality, and outcomes.

What you will do

• Support the Chief Medical Director in directing medical management, utilization management, quality improvement, and credentialing functions.
• Lead medical review activities for utilization review, quality assurance, complex cases, controversial services, experimental treatments, claims, and medical necessity appeals.
• Conduct rounds for high-risk patients and coordinate care with care management teams, clinical teams, network providers, and consultants.
• Support performance improvement initiatives for capitated providers and identify trends in utilization, provider practice patterns, and clinical quality.
• Participate in physician committees, provider network development, market expansion, and physician education.
• Represent the business unit in state committees and other public or industry settings when needed.

Requirements

• Medical Doctor or Doctor of Osteopathy degree.
• Active medical practice and a current, unrestricted state MD or DO license without government-program restrictions, limitations, or sanctions.
• Board certification in a specialty recognized by the American Board of Medical Specialists or the American Osteopathic Association’s Department of Certifying Board Services.
• Utilization management experience and knowledge of quality accreditation standards are preferred.
• Experience treating or managing care for culturally diverse populations is preferred.
• Must be eligible to work in the United States and meet applicable state licensure requirements.

Nice to have

• Certification in Internal Medicine or Family Medicine.
• Coursework in health administration, health financing, insurance, or personnel management.

Culture & Benefits

• Remote, hybrid, field, and office work schedules are supported; this position is remote.
• Health insurance, 401(k), stock purchase plans, tuition reimbursement, paid time off, and holidays.
• Competitive pay adjusted for skills, experience, education, and other job-related factors.
• Equal opportunity workplace with a stated commitment to diversity and inclusion.
• Weekend and holiday work may be required to support business operations.