Medical Director, Denials Management (FT/M-F/REMOTE) (No UM exp. req’d)

CorroHealth

Tennessee, United States Full-time in Healthcare & Medical
    • Job ID 1747210

    Job Description

    For the quickest response, please apply directly via CorroHealth’s website. Click Company>Careers>Medical Director, Denials Management>Apply. Thank you.

    About CorroHealth:
    At CorroHealth our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals.

    We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success.

    JOB SUMMARY:

    As a Medical Director, Denials Management you will have the unique opportunity to evaluate hospitalizations across the country while utilizing your medical knowledge and gaining experience as an expert advisor to client hospitals. You will perform clinical case reviews and provide recommendations that focus on establishing the appropriate admission status. CorroHealth offers a career path that allows you to continue using your clinical knowledge, drive value to hospitals while providing you with a predictable schedule. This opportunity allows for the work/life balance you desire while expanding your knowledge base in Utilization Review.

    The Impact You Will Have:

    CorroHealth is led by like-minded clinicians who share the same innate calling to help. Hospitals nationwide have recently struggled with managing complex and unforeseen challenges such as global pandemics, complex regulatory updates, and downstream policy changes set forth by Medicare and private payer organizations resulting in financial difficulty. CorroHealth physicians lead challenging and rewarding careers by providing our hospital clients with guidance to improve compliance and ensure appropriate payment for the care delivered. The impact of your role will allow attending physicians to focus on what is most important, providing dedicated care to the patients they serve.

    Your Schedule:

    Training (The first 3-4 weeks):

    • Training will occur Monday-Friday 9A-5P ET

    After Completion of Training:

    • Schedule will be Monday-Friday, anywhere between 8a-5p ET to 10a-7p ET.
    • Each of your shifts will be 9 hours in length, which includes one hour of dedicated break time.
    • Includes an expectation of 1 weekend 6-hour shifts of prep for peer-to-peer cases, within a 6-week business period

    Working at CorroHealth:

    • All necessary hardware and software is provisioned to each of our Medical Directors
    • You have the ability to work remotely in a comfortable environment

    In This Role You Will:

    • Perform Peer-to-Peer case discussions with payer medical directors
    • Utilize clinical expertise to identify the salient points within a case review
    • Perform focused real-time and post-discharge hospital case reviews in hospital s EMR
    • Identify areas of process improvements and inefficiencies
    • Perform related duties and projects as assigned

    Do You Have What It Takes?

    • MD or DO degree with strong clinical knowledge
    • Active unrestricted medical license in at least one state within the United States
    • Required specialization in Adult Internal Medicine, Emergency Medicine, Hospitalist, Nephrology, or Infectious Disease; Board certification (preferred)
    • At a minimum, 1 year of acute care adult hospital experience in a US hospital within the past 5 years or recent relevant physician advisor experience
    • Working knowledge of hospitals EMR
    • Computer proficient
    • Excellent verbal and written communication skills
    • Team Player

    We Offer:

    • Quality of life with a remote predictable, full-time schedule
    • Comprehensive training and education program
    • Opportunities for career growth within the organization
    • Salary plus bonus opportunities
    • Medical, Dental, Vision coverage, 401K
    • Holidays, paid time off, short term and long-term disability insurance, and life insurance
    • Allowance for CME and/or license renewals

    ESSENTIAL DUTIES AND RESPONSIBILITIES:
    Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member s performance objectives as outlined by the Team Member s immediate Leadership Team Member.

    PHYSICAL DEMANDS:
    Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described.
    Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines.
    A job description is only intended as a guideline and is only part of the Team Member s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

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