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Role Description

Seeking a highly skilled and detail oriented Medical Director to join our team. The Medical Director will play a critical role in assessing the quality of clinical services provided to Medicare beneficiaries ensuring compliance with clinical guidelines and regulations while helping to drive improvements in care delivery. After completion of mentored training, daily work includes:

• Reviewing and analyzing clinical records, charts and case files.
• Ensuring that all clinical practices, treatments and services provided to Medicare beneficiaries meet the highest standards of care and adhere to CMS regulations, policies and procedures.
• Working closely with multidisciplinary teams to provide insights and feedback on clinical cases and improvement opportunities.

Qualifications

• Board-certified clinician (Doctor of Medicine or Doctor of Osteopathy) identified by an individual NPI in a specialty recognized by the American Board of Medical Specialties.
• Board certified for at least 3 years.
• Currently hold an active, valid and unrestricted license to practice medicine in at least one U.S. state or the District of Columbia.
• Must not be excluded from participating in Medicare, Medicaid or the Children’s Health Insurance Program.
• State of Washington license to practice medicine preferred or willingness to obtain.
• Associated with a primary specialty designation that aligns with PMR, neurology, pulmonology, urology, or orthopedics.
• Utilization management experience preferred.

Requirements

• Excellent communication skills (both verbal and written) with the ability to collaborate effectively with diverse healthcare teams.
• Familiarity with electronic health records (EHR) and documentation and coding practices (ICD-10, CPT).
• Knowledge of CMS regulations and Medicare requirements.
• Strong attention to detail and organizational skills to manage multiple tasks and priorities.
• Ability to work in a fast paced, deadline driven environment.
• This position requires some weekend shifts.
• Primarily remote with occasional on-site requirements.
• Occasional travel may be required for team meetings and onsite reviews.

Benefits

• $125 per hour.
• Conduct Prior Authorizations for High Risk procedures performed on patients of advanced age.
• Immediate Start (~2-3 weeks).
• Likely transition from Independent Contractor to Full Time Employee over time.
• Extensive Virtual Training.
• Work from Home/Company provides PC/Laptop.
• 40 hour per week is highly preferred.
• Comprehensive training and education program.
• Opportunities for career growth within the organization.