What are the responsibilities and job description for the Utilization Management Medical Director - Remote in US position at Gainwell Technologies LLC?
It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development.
Summary
Gainwell Technologies is seeking a Kentucky Utilization Review Medical Director. This role helps maintain the integrity of the payment integrity program. The person in this position will play a vital role in supervising the audit process, performing reviews, and interacting with the state quarterly.
Your role in our mission
- Reviews claims selected for prior authorization for DME, LTAC, an SNF
- Review claims for post payment review using InterQual
- Communicates with the state on quarterly reports
- Provide Quality control for the state’s Utilization Review program.
- Communicate with physician reviewers regarding program issues
- Communicate and present billing trends and findings to team members and DHCS
What we're looking for
What you should expect in this role
Monday through Friday work schedule (30-40 hours per week).
24MBS download and
8 MBS upload . Greater speeds will of course provide better performance.
To Test your internet download and upload speed :
Go to Google.
Internet Speed Test .
This position is intended for pipelining. We will accept applications on an ongoing basis.
The pay range for this position is $100,000 - $150,000 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits , and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.
We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.
Gainwell Technologies is committed to a diverse, equitable, and inclusive workplace. We are proud to be an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. We celebrate diversity and are dedicated to creating an inclusive environment for all employees.
Salary : $100,000 - $150,000
