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обновлено 6 дней назад

Utilization Management Medical Director (Medical)

Формат работы
remote (только USA)
Тип работы
parttime
Грейд
director
Английский
b2
Страна
US
Вакансия из списка Hirify.GlobalВакансия из Hirify Global, списка международных tech-компаний
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Описание вакансии

Текст:
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TL;DR
Utilization Management Medical Director (Medical): Performing clinical reviews and conducting peer-to-peer discussions for Medicare utilization management with an accent on regulatory compliance and quality of care. Focus on executing acute and post-acute clinical rounds and serving as a subject matter expert for clinical staff.

Location: Remote (USA)

Company

hirify.global is a healthcare company focused on improving the well-being of older Americans through an integrated care platform merging data and AI.

What you will do

  • Perform clinical reviews including Part A, B, appeals, and quality of care.
  • 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 throughout the health plan.
  • Participate actively in acute and post-acute clinical rounds.

Requirements

  • Broad state licensure coverage.
  • Experience in Medicare Utilization Management.
  • Must be based in the USA.
  • Willingness to obtain additional state licenses.
  • Comfort with learning and adapting to new technologies.

Culture & Benefits

  • Fully remote work arrangement.
  • Flexible scheduling.
  • Mission-driven environment focused on elderly care.

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