Job Description:
A rapidly growing healthcare information technologies company focused on medical claims editing is seeking a Medical Director for the Medical Policy Department.  The ideal candidate will have extensive claims and coding knowledge in a payor environment.  The role of the Medical Director is instrumental in directing the Logic Committee (Medical Policy Committee) which is composed of medical directors, coding analysts, provider relations, contracting people, etc.  The Logic Committee goes through the Global Medical Policy document as it relates to claims coding and then subsequently reviews individual edits that have potential value for the client. The Medical Director is also involved with the 10 Medical Policy analysts, helping them to evaluate and validate the editing information they identify from multiple sources (CMS, LMRP, specialty academies, coding newsletters, etc.).   The Medical Directors are also responsible for interacting with our Expert Panel of coding specialists who are also used to validate the clinical defensibility of our library.  Finally, the Medical Directors are involved with product enhancements and product development.

Company:
Healthcare Information Technologies Company

Requirements:
Oversees implementation of new clients.  Heads Logic Committee.  Reviews and Validates edits and explains to clients.  Interacts with Medical Expert Panel.  Interacts with Client Services and Business Decision Support.  MD/DO required.  MBA Preferred.  Previous employment with a Payor is strongly preferred.  Medical Coding Expert.

Location:
This position can be based from a home office anywhere in the United States.