HealthAxis Group
Healthcare Insurance • SaaS • Fintech
HealthAxis Group is a technology solutions provider specializing in healthcare administration. Their cloud-native platform, AxisCore™, streamlines health plan management through solutions like claims processing and benefit administration, designed to enhance operational efficiency. HealthAxis offers a suite of services including Business Process as a Service (BPaaS), consulting, and staff augmentation. The company's approach focuses on scalability, compliance, and tailored support, aiming to empower healthcare organizations to meet member needs effectively.
Medical Director, Utilization Management
Job not on LinkedIn
October 22
HealthAxis Group
Healthcare Insurance • SaaS • Fintech
HealthAxis Group is a technology solutions provider specializing in healthcare administration. Their cloud-native platform, AxisCore™, streamlines health plan management through solutions like claims processing and benefit administration, designed to enhance operational efficiency. HealthAxis offers a suite of services including Business Process as a Service (BPaaS), consulting, and staff augmentation. The company's approach focuses on scalability, compliance, and tailored support, aiming to empower healthcare organizations to meet member needs effectively.
📋 Description
• Provides medical expertise and decision-making within the Utilization Management team • Ensures healthcare services are medically necessary and appropriately utilized • Reviews clinical cases and collaborates with various stakeholders • Participates in case reviews and medical necessity determination • Conducts post-service reviews issued for medical necessity and benefits determination coding • Analyzes aggregate data and reports to primary care physicians • Serves as the liaison between physicians and health plan Medical Directors • Identifies process improvements opportunities and inefficiencies
🎯 Requirements
• Doctor of Medicine (M.D.) or Doctor of Osteopathy (D.O.) degree • Preferably, Board Certified Family Practitioner or Internal Medical Specialist • Unrestricted licensed in at least one state within the United States • 5+ years of clinical practice experience • 2+ years of experience in utilization management activities • Proficiency with Microsoft Office applications • Strong interpersonal skills • Self-starter with strong organizational skills • Excellent oral and written communication skills
🏖️ Benefits
• HealthAxis is a prominent provider of core administrative processing system (CAPS) technology and business process outsourcing (BPO) capabilities • Commitment to a people-first approach • Opportunity to be involved in additional responsibilities such as special projects
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