Medical Director - Medicare Appeals

Posted 2025-05-31
Remote, USA Full-time Immediate Start
    Description:
  • Responsibilities of this Medical Director role are related to Part C Medicare Appeals
  • Provide support to Medicare appeal nurses
  • Provide after hours and weekend coverage on a rotational basis
  • Collaborative work with Medicare Quality and Compliance on an ongoing basis
  • Provide ongoing education/subject matter expertise regarding Medicare policy and appeals
  • Participate in ongoing initiatives to improve appeals team efficiency and clinical consistency
    Requirements:
  • Two (2) or more years of experience in a Health Care Delivery System
  • Medical License (MD) or (DO)
  • An Active state medical license without encumbrances
  • Board Certified in ABMS Recognized Specialty
  • Medical Management - Medicare Complaints, Grievance & Appeals experience (preferred)
  • Health Plan Experience Highly Preferred
    Benefits:
  • Affordable medical plan options
  • 401(k) plan (including matching company contributions)
  • Employee stock purchase plan
  • No-cost programs for all colleagues including wellness screenings
  • Tobacco cessation and weight management programs
  • Confidential counseling and financial coaching
  • Paid time off
  • Flexible work schedules
  • Family leave
  • Dependent care resources
  • Colleague assistance programs
  • Tuition assistance
  • Retiree medical access
  • Many other benefits depending on eligibility

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