Chief Medical Officer – Medicare Policy

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

📋 Description

• Assists in operational tasks through case reviews related to both medical and regulatory issues.

• Establishes claim adjudication criteria for cases that necessitate medical judgment.

• Contributes insights on operational policies, processes, and procedures.

• Provides education to staff and the medical community regarding various facets of medical policy and program administration.

• May create and revise medical policies in collaboration with relevant regulatory personnel, medical consultants, and professional organizations.

• Fosters external relationships with the medical community, acting as a liaison between these entities and contractors.

• Analyzes physician and provider practice patterns along with statistical data concerning atypical medical service utilization.

• Engages in research on novel or contentious medical procedures and technologies.

⛳️ Requirements

• Doctorate in a relevant field.

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

• 5 years of post-graduate experience in direct patient care.

• Exceptional verbal and written communication skills.

• Strong customer service, organizational, and presentation abilities.

• Sound judgment skills.

• Proficient in spelling, punctuation, and grammar.

• Capability to persuade, negotiate, or influence others.

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

• Familiarity with medical and utilization review methods.

• Proficient in Microsoft Office applications.

🏝️ Benefits

• Subsidized health plans, including dental and vision coverage.

• 401k retirement savings plan with company match.

• Life Insurance.

• Paid Time Off (PTO).

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

• Education Assistance.

• Service Recognition.

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