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The Medical Director, Medicare (MDM) provides organizational leadership in the Population Health (PH) Medicare Line of Business (LOB) under the direction of the Medicare (MC) CMO, in areas such as care management, utilization management/medical cost, quality results, provider performance and policy, to advance ACFC and Medicare Plan objectives and improve the health of our member population.
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Minimum 5 years of experience as a Medical Science Liaison in the biopharmaceutical industry with a focus on hematology/oncology. Provide support for congress meetings, including scientific coverage, competitive intelligence, medical booth staffing and external engagements.
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Responsible for performing clinical reviews of medical records and other documentation to evaluate issues of coding and DRG assignment accuracy. Integrates medical chart coding principles, clinical guidelines, and objectivity in the performance of medical audit activities.
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Review coding and other information available in the patient's medical records to substantiate accuracy of billing information or to support the appeal of an incorrect denial or reimbursement from a third party payor.
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SolutionHealth is an integrated health system uniquely focused on providing access to high-value, primary, and specialty care that meets the growing needs of the communities we serve.
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In addition to a competitive salary and retirement plans, we ensure our team feels supported in their benefits beyond the typical medical, dental, and vision offerings. At St. Lukes, we pride ourselves on fostering a workplace culture that values diversity, promotes collaboration, and prioritizes employee well-being.
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Job Description Searching for a new Med Tech job?
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We are seeking highly motivated sales representatives to join our team as we expand our brand to $800m+ in the next 36-42 months in North America.
$50,000 - $250,000 a yearFull-timeRemoteExpandApply NowActive JobUpdated 6+ months ago
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