Job Details: Medical Director

Description: We are currently seeking a Medical Director to support a growing client base while combining their clinical expertise with payment policy.

Position Summary:
The Medical Director is a key member of the client team and represents the team on all Medical Policy decisions as well as directing the Medical Policy Committee-(which is composed of Medical Directors, Coding Analysts, and Provider Relations.) The Medical Director is also responsible for interpreting and assessing payment policy for clients and provides consultation and policy advice. The Medical Director will guide both internal and external processes as related to policy assessment and interpretation.

Major Duties and Responsibilities:
• Presents payment policy to clients for selection.
• Works with Medical Policy team, helping them to evaluate and validate the editing.
• Directing the research & development efforts of our Medical Policy team
• Acts as a clinical liaison with our health plan clients
• Supporting new sales activity and existing client growth by identifying value creation opportunities for our clients
• In depth knowledge of claims, claims adjudication, medical policy rules and edits

Required Skills:
• Must be an MD with Clinical experience as well as experience within a payer organization
• 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 coding and reimbursement company is a definite plus.
iHealth Technologies offers a comprehensive benefits package including medical and dental coverage, 401(k) Plan, Profit sharing, vacation, paid holidays

iHealth Technologies supports a diverse workforce and is an Equal Opportunity Employer, M/F/D/V
Invest in your career and join a growing Healthcare service and solution leader.

Interested in applying for this position, please send your resume or CV to judy.brower@ihealthtechnologies.com or visit our website www.ihealthtechnologies.com

Posting Date: Jul 14 08