Medical Director - Medicare Appeals

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Requirements:

• Two (2) or more years of experience in a Health Care Delivery System e.g., Clinical Practice or Health Care Industry
• Medical License (MD) or (DO)
• An Active state medical license without encumbrances

Responsibilities:

• Provide support to Medicare appeal nurses
• Provide after hours and weekend coverage on a rotational basis to support 72 hour turn around time
• Collaborative work with Medicare Quality and Compliance on an ongoing basis
• Provide ongoing education/ subject matter expertise regarding Medicare policy and appeals to the territory Utilization Management staff
• Participate in ongoing initiatives to improve appeals team efficiency and clinical consistency