Chief Medical Officer – Medicare Policy

This is a fully remote position, open to applicants in Tennessee.

📋 Description

• Oversees administrative functions for the medical staff.

• Evaluates data related to medical review utilization.

• Investigates new medical procedures or technologies.

• Serves as a primary resource for providers and internal staff regarding medical policy issues.

• Plays a significant role in policy development, including creating new policies and revising existing ones.

• Aids operations through case reviews involving both medical and regulatory issues.

• Establishes claim adjudication criteria for scenarios that require medical judgment.

• Provides education to staff and the medical community on various facets of medical policy and program management.

• Formulates and updates medical policies in collaboration with regulatory personnel, medical consultants, and professional organizations.

• Builds external connections with the medical community and acts as a liaison between these groups and contractors.

• Analyzes physician and provider practice patterns and other statistical data related to atypical medical service utilization.

• Conducts investigations into new or contentious medical procedures and technologies.

⛳️ Requirements

• Doctorate in a relevant field.

• Valid state medical license and current board certification in a recognized specialty.

• Five years of postgraduate experience in direct patient care.

• Strong verbal and written communication abilities.

• Exceptional customer service, organizational, and presentation skills.

• Sound judgment capabilities.

• Proficient in spelling, punctuation, and grammar.

• Ability to persuade, negotiate, or influence others effectively.

• Capacity to function as both a team member and a leader.

• Understanding of medical and utilization review techniques.

• Proficiency in Microsoft Office applications.

🏝️ Benefits

• Subsidized health plans, including dental and vision coverage.

• 401k retirement savings plan with company matching.

• Life Insurance coverage.

• Paid Time Off (PTO).

• On-site cafeterias and fitness centers available in major locations.

• Education Assistance programs.

• Service Recognition initiatives.

• National discounts for movies, theaters, zoos, theme parks, and more.