Medical Director

4 days ago


Owings Mills, Maryland, United States Nhassociates Full time
Job Summary

Nhassociates is seeking a highly skilled Medical Director to lead our team in a CERT Program opportunity. This is a 100% remote work opportunity.

Job Responsibilities

The Medical Director will serve as a key member of our team, responsible for:

  1. Leadership and Collaboration: Provide leadership and guidance to healthcare professionals, including interacting with medical societies and peer groups.
  2. Clinical Expertise: Develop and implement clinical policies and guidelines, including LCDs and internal MR guidelines.
  3. Education and Training: Educate healthcare providers on identified problems or LCDs, and provide guidance on the correct application of policy during claim adjudication.
  4. Quality Assurance: Ensure that LCDs and associated internal guidelines are appropriate and effective in reducing improper payments.
  5. Communication and Collaboration: Interact with other contractors to share information on potential problem areas, and participate in clinical workgroups as appropriate.
Requirements

To be successful in this role, the Medical Director must have:

  1. Doctor of Medicine or Doctor of Osteopathy Degree
  2. Current licensure to practice medicine
  3. A minimum of three (3) years of experience practicing medicine as a board-certified physician
  4. Experience in the health insurance industry, a utilization review firm, or another health care claims processing organization
  5. Extensive knowledge of the Medicare program, particularly the coverage and payment rules
  6. Public relations experience, such as working with physician groups, beneficiary organizations, and/or congressional offices
Company Overview

Nhassociates is a small, SBA 8(a) certified and minority-owned business built on a tradition of reliability, accuracy, and responsiveness to the needs of our clients. We have delivered over 20 years of top-notch performance within the public sector, particularly for the Centers for Medicare & Medicaid Services (CMS), as well as for consulting firms, insurers, employers, and healthcare companies.


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