Medical Director

🕒 August 14

🇺🇸 United States – Remote

💵 $225k - $275k / year

⏰ Full Time

🔴 Lead

👨‍⚕️ Medical Director

🦅 H1B Visa Sponsor

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👻 Ghost score 26%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Cotiviti

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

🏥 Healthcare

💼 Consulting

📦 Logistics

Healthcare • Consulting • Logistics

Cotiviti is a healthcare technology and analytics company that specializes in improving payment accuracy and performance through advanced data analytics solutions. They partner with health plans, government agencies, and healthcare providers to deliver insights that enhance quality and efficiency in care delivery. With solutions such as risk adjustment, payment policy management, and member engagement, Cotiviti aims to optimize financial and clinical outcomes for the healthcare ecosystem.

📋 Description

• Support existing client growth and new sales activity by identifying value-creation opportunities • Present appropriate payment policy to clients for adoption based on review of data analytics • Define mission and strategy with the Client Engagement Leader and deliver strategy to the client’s medical policy team • Work alongside the Medical Policy team to evaluate and validate editing • Act as a clinical liaison with health plan clients • Guide research and development efforts for Medical Policy and Solutions teams • Serve as a coding and medical payment policy subject matter expert • Direct the Medical Policy Committee with health plan physicians, coding experts, and payment integrity stakeholders • Develop client relationships, review client data, select medical policies to present, and provide clinical and coding expertise • Provide back-end support for the client’s Medical Director • Build trusted-advisor relationships with health plans regarding medical payment policy • Assist in discovering opportunities for other Cotiviti product sales • Inspire trust and credibility, deliver on commitments, and provide value-add analytics • Perform other duties as assigned

🎯 Requirements

• Licensed MD/DO with clinical and health plan experience • Experience in health plan operations as a Medical Director, with focus on medical policy, medical coding, payment integrity and/or fraud/waste/abuse • Experience in clinical medicine • Adaptive capacity for rapidly changing priorities and workloads, multitasking, prioritizing and meeting deadlines • Ability to develop strong professional relationships with multiple roles and levels • Comfortable presenting to small and large groups • Strong organizational, analytical and problem-solving skills • Results driven with focus on producing high-quality, error-free service and deliverables • Ability to work well independently and in a team environment • Excellent verbal and written communication skills • Proficient with Microsoft Office Suite (Word, Excel, PowerPoint); advanced Excel proficiency preferred • Ability to work at home anywhere in the continental United States • Approximately 10% travel required • Ability to use a computer keyboard for extended periods • Ability to provide a dedicated, secure work area • Ability to provide high-speed internet access/connectivity and office setup and maintenance • After-hours and/or weekend work may be required for major deliverables/deadlines

🏖️ Benefits

• Discretionary bonus consideration • Medical insurance coverage • Dental insurance coverage • Vision insurance coverage • Disability insurance coverage • Life insurance coverage • 401(k) savings plans • Paid family leave • 9 paid holidays per year • 17–27 days of Paid Time Off (PTO) per year, depending on specific level and length of service • Work at home anywhere in the continental United States • High-speed internet access/connectivity and office setup and maintenance provided by the team member