Medical Director - Inpatient Review

CarePlus Health Plans Inc

Base: $223,800 - $313,100 py; bonus: eligible for ...
Hybrid
Md or do degree required
5+ years post-residency clinical experience
Active unrestricted medical license
CarePlus Health Plans Inc. is seeking a Medical Director for Inpatient Review, responsible for assessing medical necessity in inpatient care. The role requires a physician with significant clinical experience and strong analytical skills, offering an opportunity to enhance patient outcomes in a collaborative environment

Job Summary

  • The role involves performing expert clinical reviews of inpatient medical records to assess medical necessity based on national guidelines and CMS regulations.
  • Physicians will collaborate within a structured team environment to advance the mission of high-quality, consistent decision-making and foster strong physician partnerships.
  • The position offers competitive benefits including medical, dental, vision, 401(k) retirement savings, and paid time off while working from home with standard business hours.

Matching Summary

Match Score: 85

CarePlus Health Plans Inc. is seeking a Medical Director for Inpatient Review, responsible for assessing medical necessity in inpatient care. The role requires a physician with significant clinical experience and strong analytical skills, offering an opportunity to enhance patient outcomes in a collaborative environment.

Salary

Base: $223,800 - $313,100 per year; Bonus: Eligible for incentive plan based on performance; Benefits: Medical, dental, vision, 401(k), PTO, disability, life insurance

Skills & Requirements

Must-have

  • MD or DO degree required
  • 5+ years post-residency clinical experience
  • Active unrestricted medical license
  • Board certification in recognized specialty
  • Inpatient medical record analysis skills

Nice-to-have

  • Prior utilization management experience
  • Familiarity with MCG or InterQual guidelines
  • Experience with Medicare populations
  • Proficiency with clinical technology platforms
  • Interest in educational content creation

Key Requirements

  • MD or DO degree
  • 5 or more years post-residency clinical experience
  • Active unrestricted medical license
  • Current Board Certification
  • No state or federal sanctions

Work Rights

Not specified

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