A leading healthcare technology company that provides solutions for healthcare organizations, has a unique experience base, extensive healthcare information and advantaged technology applications which create value through reduced medical costs, reduced administrative costs and improved care coordination is seeking a Medical Director to support a growing client base and maintain their competitive advantage in the depth of clinical logic.

 
Responsibilities
Direct the research and development efforts of our Medical Policy team
Act as clinical liaison with our health plan clients
Support new sales activity and same-store growth by identifying value creation opportunities for our clients
In depth knowledge of claims, claims adjudication, medical policy rules and edits

 
Required Skills
MD required
Clinical and payer organization experience
Some experience in private sector/health plan operations as a Medical Director, with focus on reimbursement, medical coding (CPT, ICD-9)
Consulting experience within a healthcare technology company a plus