Medical Director (Medicare)

Responsibilities: Provide medical leadership and clinical expertise to support Medicare claims review, coverage decisions, and healthcare policy initiatives. Collaborate with government stakeholders and internal teams to improve program operations and ensure regulatory compliance.

Requirements: Requires a board-certified MD or DO with at least four years of professional medical practice and deep knowledge of Medicare programs. Candidates must have experience in healthcare insurance, utilization review, or similar policy-driven environments.

Key skills: Medicare Policy, Medical Review, Clinical Judgment, Regulatory Compliance, Claims Review, Medical Necessity Evaluation, Stakeholder Engagement, Healthcare Policy, CMS Regulations, Medical Coding, Clinical Guidelines, Strategic Advisory, Communication, Analytical Thinking, Decision Making, Collaboration

Keywords: Medicare, CMS, Medical Director, Medical Necessity, Utilization Review, Claims Processing, Healthcare Compliance, Board Certification, MD, DO, Medical Licensure, Healthcare Policy, Regulatory Guidance, Medical Documentation, Coding Guidelines, Microsoft Word, Excel, SharePoint, Healthcare Insurance