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Utilization Management Medical Director Contractor

Role overview

Qualifications

  • Broad state licensure coverage
  • Medicare Utilization Management experience
  • Comfort with learning and adapting to new technologies
  • Willingness to obtain other state licenses

Responsibilities

  • Perform clinical reviews (i.e., part A, B, appeals, quality of care) and conduct peer to peer discussions
  • Participate in inter-rater reliability activities
  • Serve as a clinical resource and subject matter expert to both clinical and non-clinical staff throughout the Devoted Health Plan
  • Active participation in acute and post acute clinical rounds

Key facts

Other skills

  • Adaptability
  • Communication
  • Teamwork

About the company

Devoted Health logo

Devoted Health

Health Insurance (Payers)

Devoted Health is a new healthcare company serving seniors. Our mission is to dramatically improve the health and well-being of older Americans by caring for each and every person like they are family. We are devoted to the health and wellness of our members by helping them navigate the healthcare system with personal guides, by utilizing world-class technology to enable a simplified experience, and by partnering with top providers for better health outcomes.

Company details

Company typeScaleup
IndustryHealth Insurance (Payers)
Company size1001 - 5000

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Job description

Job Description

Job Type: Part-time Contractor 

Required Skills and Experience:

  • Broad state licensure coverage

  • Medicare Utilization Management experience

  • Comfort with learning and adapting to new technologies

  • Willingness to obtain other state licenses

Your Responsibilities will include:

  • Perform clinical reviews (i.e., part A, B, appeals, quality of care)  and conduct peer to peer discussions. 

  • Participate in inter-rater reliability activities. 

  • Serves as a clinical resource and subject matter expert to both clinical and non-clinical staff throughout the Devoted Health Plan.  

  • Active participation in acute and post acute clinical rounds. 

Benefits include:

  • Flexible schedule

  • Fully remote work

The pay range listed for this position is the range the organization reasonably and in good faith expects to pay for this position at the time of the posting. Once the interview process begins, your talent partner will provide additional information on the compensation for the role, along with additional information on our total rewards package. The actual base salary offered will depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.

Our Total Rewards package includes:

  • Employer sponsored health, dental and vision plan with low or no premium

  • Generous paid time off

  • $100 monthly mobile or internet stipend

  • Stock options for all employees

  • Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles

  • Parental leave program

  • 401K program

  • And more....

*Our total rewards package is for full time employees only. Intern and Contract positions are not eligible.

Founded in 2017, Devoted Health is on a mission to dramatically improve the health and well-being of older Americans by caring for everyone like they are family, and that includes our employees. Our robust and seamlessly integrated care platform merges advanced data and AI access with world-class clinical and service experiences to create a member experience that is unlike the industry norm. To continue building upon our mission, we want to bring together those who share our values, embrace change and advancement, and are enthusiastic about where we're going β€” all the while bringing their own unique qualities, experiences, and expertise, in hopes of further changing the healthcare experience.


Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted’s Code of Conduct, our company values and the way we do business.


As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.

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MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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