Physical Medicine and Rehabilitation Medical Director

This is a fully remote position, open to applicants in Hawaii, +3 more states.

📋 Description

• Oversee administrative functions for the medical staff

• Evaluate utilization data from medical reviews

• Facilitate operations by reviewing cases related to medical and regulatory issues

• Create criteria for claim adjudication in cases that necessitate medical judgment

• Contribute to the development of operational policies, processes, and procedures

• Provide education to staff and the medical community on medical policies and program management

• Collaborate with regulatory personnel, medical consultants, and professional societies to develop and update medical policies

• Build external relationships within the medical community

• Act as a liaison between medical entities and contractors

• Analyze physician and provider practice patterns along with statistical data concerning unusual medical service utilization

• Investigate new or contentious medical procedures and technologies

• May draft and amend medical policies

⛳️ Requirements

• Doctorate in a relevant field

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

• Proficient in Microsoft Office Suite

• Exceptional verbal and written communication abilities

• Strong customer service, organizational, and presentation skills

• Good judgment and decision-making skills

• Proficient in spelling, punctuation, and grammar

• Ability to persuade, negotiate, or influence others effectively

• Capability to function as both a team member and a leader

• Familiarity with medical and utilization review techniques

• Active state medical license

• Current board certification in a recognized specialty

• Eligibility to obtain a security clearance

• Must be a U.S. Citizen

• Not eligible for sponsorship now or in the future

• Preferred: experience in the health insurance industry

• Preferred: experience in inpatient rehabilitation

• Preferred: knowledge and experience with Medicare policies

🏝️ Benefits

• Subsidized health plans

• Dental and vision coverage

• 401k retirement savings plan with company match

• Life Insurance

• Paid Time Off (PTO)

• On-site cafeterias and fitness centers in major locations

• Education Assistance

• Service Recognition

• National discounts to movies, theaters, zoos, theme parks, and more

• Diverse and inclusive workplace

• Reasonable accommodations for disabilities, pregnancy-related conditions, and sincerely held religious beliefs