Wednesday, April 13, 2011

Job post: Associate Medical Director -- Physician Reviewer

Here's another job post that may be of interest:

Associate Medical Director -- Physician Reviewer

Job Responsibilities:
  • On site resource for the staff for medical review;
  • Duties may include but not limited to: adjudication of appeals, clinical panel medical review, research, development, and training for the medical review staff.
  • Functions as liaison to the medical consultant panel.
  • Researches controversial medical procedures or technology.
  • Clarifies coding and medical necessity issues.
  • Maintains familiarity with Medicare regulations as required by position.
  • Provides recommendations to facilitate operational efficiencies.

  • Doctor of Medicine (M.D.) or Doctor of Osteopathy (D.O.) degree; active and unrestricted license in the United States.
  • Board Certification in American Board of Medical Specialties (ABMS) recognized specialty.
  • Geriatric Medicine, Physiatry, Internal Medicine or Family Medicine strongly preferred.
  • Broad clinical experience of minimum of 5 years to include experience with inpatient care settings such as Skilled Nursing Facilities, Acute Inpatient Care, Acute Inpatient Rehabilitation and/or Long Term Acute Care.
  • Knowledge of medical review and utilization review.
  • Preferred two years experience with Medicare rules & regulations with a demonstrated understanding of the Medicare program.
  • Preferred two years experience in medical data analysis and analytical capability to interpret statistical information.
  • Experience serving on medical staff committees, quality improvement activities, credentialing activities, etc, preferred.
  • Experience in education and training preferred.
More information here.

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