Medical Director

New Today

Medical Director Assist the Chief Medical Director in directing and coordinating medical management, quality improvement, and credentialing functions for the business unit. This role is within the Medicare line of business, overseeing the Medicare product team and collaborating closely with Population Health and Clinical Operations partners. Responsibilities: Work closely with the Medicare Inpatient Pod specializing in Concurrent Review, Post Acute Care Reviews, Pre-Service, and Par Retro/Claims Appeals for Inpatient and Post-Acute Care Stays. Handle a large volume of inpatient and post-acute care cases. Assist members with discharge needs and transition them to the next best level of care. Provide resources to help avoid readmissions and ensure a smooth transition home with necessary DME/services. Essential Skills: Licensed in Internal Medicine or Family Medicine. Must have a medical license in Florida and Texas, with a preference for additional licenses in MI, MS, NJ, NC, CA, KS, and AR. Board Certification through the American Board of Medical Specialties. Experience with Medicare and utilization management using InterQual or MCG clinical guidelines. Additional Skills & Qualifications: Experience with appeals for inpatient care is nice to have. Collaborative and team-oriented mindset. Work Environment: Typically work from 8 am to 5 pm local time, with occasional extensions beyond 5 pm if necessary. Collaborate across three different platforms, frequently interacting with team members to provide and receive assistance. The team is hardworking and supportive, fostering a collaborative and helpful environment. Job Type & Location: This is a contract position based out of Sunrise, Florida. Pay and Benefits: The pay range for this position is $111.00 - $125.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: Medical, dental & vision Critical Illness, Accident, and Hospital 401(k) Retirement Plan Pre-tax and Roth post-tax contributions available Life Insurance (Voluntary Life & AD&D for the employee and dependents) Short and long-term disability Health Spending Account (HSA) Transportation benefits Employee Assistance Program Time Off/Leave (PTO, Vacation or Sick Leave) Workplace Type: This is a fully remote position. Application Deadline: This position is anticipated to close on Oct 2, 2025.
Apply
Location:
Fort Lauderdale, FL, United States
Job Type:
FullTime
Category:
Management Occupations

We found some similar jobs based on your search