OVERVIEW
Hendall is seeking a Doctor of Medicine or a Doctor of Osteopathy to serve as Chief Medical Director. The successful candidate will utilize clinical expertise and judgment to effectively focus review activities and interact with Medical Directors of other contractors, as necessary.
The position will keep abreast of medical practice and technology changes that may result in improper billing to brief review staff and ensure proper claim payment determinations.
In any questionable payment determinations, the Medical Director is responsible for providing final review decisions and direction for review staff.
Please note this is a full-time, remote position.
This position will support Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS) which serves the public as a trusted partner and steward, dedicated to advancing health equity, expanding coverage, and improving health outcomes.
The Medical Director shall possess a combination of experience and qualifications meeting the following criteria :
- A minimum of three years of experience practicing medicine as a board-certified physician with no previous sanctioning or exclusion from the Medicare program
- Experience in the health insurance industry, a utilization review firm, or another health care claims processing organization in a role that involved developing coverage or medical necessity policies and guidelines
- Extensive knowledge of the Medicare program, particularly the coverage and payment rules
- Public relations experience such as working with physician groups, beneficiary organizations, and / or congressional offices
- Education and Licensure :
- Doctor of Medicine or Doctor of Osteopathy Degree
- Current licensure to practice medicine
Hendall Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability.
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