Utilization Management Medical Director Contractor

Формат работы

remote (только USA)

Тип работы

parttime

Грейд

director

Английский

Страна

Вакансия из Hirify Global, списка международных tech-компаний
Для мэтча и отклика нужен Plus

Мэтч & Сопровод

Для мэтча с этой вакансией нужен Plus

Описание вакансии

Текст:

TL;DR

Utilization Management Medical Director Contractor (Medicare Utilization Management): Performing clinical reviews, appeals, quality-of-care assessments, and peer-to-peer discussions with an accent on Medicare utilization management and broad state licensure coverage. Focus on participating in inter-rater reliability activities, supporting clinical and non-clinical staff as a subject matter expert, and contributing to acute and post-acute clinical rounds.

Location: Remote USA

Company

hirify.global is a healthcare company improving the well-being of older Americans through an integrated care platform combining data, AI, clinical services, and member support.

What you will do

Perform Part A, Part B, appeals, and quality-of-care clinical reviews.
Conduct peer-to-peer discussions.
Participate in inter-rater reliability activities.
Serve as a clinical resource and subject matter expert for clinical and non-clinical staff across the health plan.
Participate in acute and post-acute clinical rounds.

Requirements

Broad state licensure coverage is required.
Experience in Medicare utilization management.
Ability to learn and adapt to new technologies.
Willingness to obtain additional state licenses.

Culture & Benefits

Part-time contractor engagement with a flexible schedule.
Fully remote work from the USA.
hirify.global values diversity, collaboration, change, and continuous advancement.
Contract positions are not eligible for the full-time employee total rewards package.

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