Medicare Medical Director Jobs in Union, Arkansas

Strong PC knowledge and skills

Experience in reviewing claims for technical requirements, performing medical review, and/or developing fraud cases

Make claim payment decisions based on clinical knowledge

Bachelors degree and 5-7 years, Masters degree and 3-5 years or PhD and 0-2 years of relevant experience.

Strong communication and organization skills

Ability to present issues of concern, citing regulatory violations, alleging schemes or scams to defraud the Government

Analytical, problem solving, retention of new knowledge, organizational skills.

1-2 years Moda Health claims processing experience preferred

Knowledge of medical terminology, HCPC codes, CPT codes and ICD-9/ICD-10 codes.

Demonstrated knowledge and understanding of plans processed by unit including complex claims and claims from various provider panels.

Effective written and verbal communication skills.

Performs manual calculation/override of benefit to enter correct information on claims the system cannot process.

Extensive benefits and PTO offered

Base salary of $21-25/hr (based on experience and licensures)

1-3 years experience selling Medicare health plans

Offer relevant information on several different carriers and plans

Bonus pay of $30-50 per enrollment

Active resident-state Health Insurance License (multiple states preferred)

Minimum of 5 years' experience in clinical medicine.

Minimum 3 years’ clinical trials experience as an investigator or medical /clinical expert in the Pharma, CRO, or Biotech industry.

Ability to establish and maintain effective working relationships with coworkers, managers and clients.

Strong communication, presentation and interpersonal skills.

Robust and current knowledge of scientific, clinical, regulatory, commercial and competitive landscape in applicable therapeutic area.

Proven skills in providing consultation and advice on multiple assignments are required, as well as initiative and flexibility.

Required Experience, Education And Skills

High School Diploma/GED or equivalent combination or education and experience required.

Basic math and computer skills. The ability to type 30 words per minute is a requirement.

Knowledge of medical terminology and the ability to understand and assess medical documents is strongly preferred.

Experience handling first-party medical claims is preferred.

Negotiating skills and the ability to develop effective negotiating strategies.

The Associate will be part of a small team working in a fast-paced environment, requiring excellent time management and prioritization skills.

Qualifications (Minimum education & experience level required):

Experience with Health Plan Management System (HPMS) and CMS PBP software preferred.

Experience with benefit development, CMS bid submissions, benefit implementation, regulatory documents, or claims experience is ideal.

This position requires the candidate to have experience in healthcare, preferably with Medicare programs.

This is a highly visible role and strong interpersonal skills are a necessity.

At least 7 years of project management experience

Excellent multitasking and time management skills

Overseeing a team of project Managers and insuring they are meeting all targets

Strong interpersonal, writing and verbal communication skills

Be detail-oriented and highly organized, and have the ability to proactively manage competing priorities

Be responsible for managing all projects for assigned brands from concept through completion

Urgent Care or Emergency Medicine experience

Salary commensurate with experience in the range of $250,000 - $325,000 annually!

Provide and supervise occupational health services including pre-employment screening exams, evaluation and treatment of workplace injuries, and DOT physicals.

Take calls from other providers who may need guidance with patient diagnostics, treatment, or other medical questions.

Stay abreast of current medical diagnostic and treatment modalities to ensure the highest quality patient care.

Choose your days and hours

Health/dental/vision insurance, infertility benefits, gender affirmation services

Continuing Education Allowance and paid Continuing Education Days

WOOF University – offering abundant CE for Doctors and Staff

Doctor of Veterinary degree, or equivalent, from an accredited university

Active Veterinary State License (preferred)

Innovative associate health and wellbeing department (Headspace app subscriptions, Vault financial wellness tool, and access to additional mental health resources)

At least 5 years of clinical, scientific, or industry experience, ideally in a high-volume environment

Professional and excellent interpersonal skills and a positive, diplomatic attitude

Complimentary Life Insurance $25,000; with options to purchase additional voluntary benefits for self or family

Ensure current practices, SOPs, BPGs are available and support standards of care.

Evaluate future growth of services to improve standards of care.

Foster an environment of psychological safety.

Health/dental/vision insurance, infertility benefits, gender affirmation services

Continuing Education Allowance and paid Continuing Education Days

WOOF University – offering abundant CE for Doctors and Staff

Doctor of Veterinary degree, or equivalent, from an accredited university

Active Veterinary State License (preferred)

Innovative associate health and wellbeing department (Headspace app subscriptions, Vault financial wellness tool, and access to additional mental health resources)

Health/dental/vision insurance, infertility benefits, gender affirmation services

Continuing Education Allowance and paid Continuing Education Days

WOOF University – offering abundant CE for Doctors and Staff

Doctor of Veterinary degree, or equivalent, from an accredited university

Active Veterinary State License (preferred)

Innovative associate health and wellbeing department (Headspace app subscriptions, Vault financial wellness tool, and access to additional mental health resources)

Health/dental/vision insurance, infertility benefits, gender affirmation services

Continuing Education Allowance and paid Continuing Education Days

WOOF University – offering abundant CE for Doctors and Staff

Doctor of Veterinary degree, or equivalent, from an accredited university

Active Veterinary State License (preferred)

Innovative associate health and wellbeing department (Headspace app subscriptions, Vault financial wellness tool, and access to additional mental health resources)

Health/dental/vision insurance, infertility benefits, gender affirmation services

Continuing Education Allowance and paid Continuing Education Days

WOOF University – offering abundant CE for Doctors and Staff

Doctor of Veterinary degree, or equivalent, from an accredited university

Active Veterinary State License (preferred)

Innovative associate health and wellbeing department (Headspace app subscriptions, Vault financial wellness tool, and access to additional mental health resources)

Health/dental/vision insurance, infertility benefits, gender affirmation services

Continuing Education Allowance and paid Continuing Education Days

WOOF University – offering abundant CE for Doctors and Staff

Doctor of Veterinary degree, or equivalent, from an accredited university

Active Veterinary State License (preferred)

Innovative associate health and wellbeing department (Headspace app subscriptions, Vault financial wellness tool, and access to additional mental health resources)

Health/dental/vision insurance, infertility benefits, gender affirmation services

Continuing Education Allowance and paid Continuing Education Days

WOOF University – offering abundant CE for Doctors and Staff

Doctor of Veterinary degree, or equivalent, from an accredited university

Active Veterinary State License (preferred)

Innovative associate health and wellbeing department (Headspace app subscriptions, Vault financial wellness tool, and access to additional mental health resources)

Health/dental/vision insurance, infertility benefits, gender affirmation services

Continuing Education Allowance and paid Continuing Education Days

WOOF University – offering abundant CE for Doctors and Staff

Doctor of Veterinary degree, or equivalent, from an accredited university

Active Veterinary State License (preferred)

Innovative associate health and wellbeing department (Headspace app subscriptions, Vault financial wellness tool, and access to additional mental health resources)

Health/dental/vision insurance, infertility benefits, gender affirmation services

Continuing Education Allowance and paid Continuing Education Days

WOOF University – offering abundant CE for Doctors and Staff

Doctor of Veterinary degree, or equivalent, from an accredited university

Active Veterinary State License (preferred)

Innovative associate health and wellbeing department (Headspace app subscriptions, Vault financial wellness tool, and access to additional mental health resources)

Monitors all aspects of medical quality and reports findings to senior management.

Provides clinical mentoring and coaching. Supervises staff and monitors training, continuing education and development of the clinical team (DVMs & techs).

Ensures compliance with policies and regulatory requirements.

Ensures duties, responsibilities, authority and accountability of subordinates are defined and understood.

Board certification in medical or radiation oncology, radiology, or internal medicine (DACVIM-O, DACVR-RO, DACVR, or DACVIM).

At least 10 years of clinical, scientific, or industry experience is ideally in a high-volume environment.