Medical Director

🔥 47 minutes ago

🇺🇸 United States – Remote

💵 $225k - $275k / year

⏰ Full Time

🔴 Lead

👨‍⚕️ Medical Director

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Cotiviti

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

⚕️ Healthcare Insurance

💳 Fintech

🤖 Artificial Intelligence

Healthcare Insurance • Fintech • Artificial Intelligence

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

• Supporting existing client growth and new sales activity by identifying value-creation opportunities for our clients • Presents appropriate payment policy to clients for adoption based on review of data analytics • Defines mission and strategy with Client Engagement Leader; delivers strategy to client’s medical policy team • Works alongside Medical Policy team to evaluate and validate editing • Acts as a clinical liaison with our health plan clients • Lend guidance to the research & development efforts of our Medical Policy and Solutions teams • Have in-depth knowledge of claims, claims adjudication, medical policy edits and configurations • Inspire trust and credibility, deliver on commitments, provide value-add analytics • Assist in discovering opportunities for other Cotiviti product sales • 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 • Client Relationship Skills - Ability to develop strong professional relationships with multiple roles and levels • Comfortable with presenting to small and large groups of people • 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, Power Point); advanced Excel proficiency preferred • Exhibits behaviors consistent with Cotiviti values.

🏖️ Benefits

• medical, dental, vision, disability, and 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 with Cotiviti