Medical Director – Denials Management

Position Type: Full Time

Location: Onsite positions in Newtown Square and/or remote opportunities

Versalus Health is an innovative, rapidly growing physician-led organization that provides hospitals with next-generation solutions for Fee-For-Service Medicare and Managed Care/Commercial utilization management focused on the intersection of utilization management, revenue cycle, and compliance. The company has a vibrant culture that strives to promote a positive work/life balance while allowing physicians to utilize their clinical skills in an environment that positively impacts healthcare. Versalus’ Medical Directors collaborate on teams and share their medical expertise while educating hospital clients. Come be a part of the Versalus team and positively change healthcare!

Job Description: Medical Director – Denials Management

The Medical Director acts as an expert resource to client hospitals by providing case reviews in real-time, a methodology for change in admission status, a structure for submission of clinical information to the payors, and a defense of the hospital stay if needed.

Job Responsibilities:

  • Perform focused real-time case reviews with full access to EMR.
  • Determine the salient features of a hospital stay.
  • Create problem lists from the medical record to show specific hospital services provided.
  • Provide in-depth clinical expertise with clear and concise documentation.
  • Interact with attending physicians at client hospitals by text or telephone.
  • Perform Peer-to-Peer case discussions with payor medical directors.
  • Additional responsibilities available with the growth of the company.

Skills:

  • Strong clinical knowledge
  • Good communication skills
  • Team Player
  • Collaborative
  • Computer proficient
  • Good problem solver
  • Organized
  • Professional

Education/Experience Required:

  • MD or DO – active license required
  • Peer to Peer experience
  • Current or recent inpatient hospital experience
  • Medical degree and postgraduate medical training from accredited clinical programs
  • Board certification preferred
  • Previous physician advisor and/or medical director experience helpful, but not necessary

Physical Requirements:

May be expected to sit at a desk for long hours.  Repetitive movement of hands and fingers – typing and/or writing.  Occasional standing, walking, stooping, kneeling or crouching.  Ability to reach with hands and arms, talk and hear. Exert up to 20 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects

Versalus Health is an Equal Opportunity Employer and considers applicants for employment without regard to race, color, religion, sex, orientation, national origin, age, disability, genetics or any other basis forbidden under federal, state, or local law.

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