Job Description
**Become a part of our caring community**
The Lead Medical Director relies on medical background and reviews health claims. The Lead Medical Director requires a solid understanding of how organization capabilities interrelate across department(s).
The Lead Medical Director provides clinical and operational leadership for medical review activities supporting Home Health, Skilled Nursing Facility, Durable Medical Equipment, Medicare/Medicaid dual-eligible requests, and related home care solutions. Grounded in CMS Medicare guidance and applicable regulatory requirements, this role ensures consistent, timely, fair, compliant, and evidence-based medical necessity determinations for Medicare, Medicaid, and Dual Eligible populations.
**Leadership and Team Operations**
+ **Oversee daily operations of** a team of Medical Directors conducting appeals and clinical case reviews for Medicare and Dual Eligible populations.
+ Maintain Medical Director staffing schedules, including p...
The Lead Medical Director relies on medical background and reviews health claims. The Lead Medical Director requires a solid understanding of how organization capabilities interrelate across department(s).
The Lead Medical Director provides clinical and operational leadership for medical review activities supporting Home Health, Skilled Nursing Facility, Durable Medical Equipment, Medicare/Medicaid dual-eligible requests, and related home care solutions. Grounded in CMS Medicare guidance and applicable regulatory requirements, this role ensures consistent, timely, fair, compliant, and evidence-based medical necessity determinations for Medicare, Medicaid, and Dual Eligible populations.
**Leadership and Team Operations**
+ **Oversee daily operations of** a team of Medical Directors conducting appeals and clinical case reviews for Medicare and Dual Eligible populations.
+ Maintain Medical Director staffing schedules, including p...