Medical Director - Medicare

Computer Sciences   •  

Omaha, NE

Industry: Consulting

  •  

Less than 5 years

Posted 358 days ago

DXC Technology has an immediate need in our US Public Sector group for a Medical Director -Medicare- in Omaha, NE or Camp Hill, PA.

 SafeGuard Services (SGS), a subsidiary of DXC Technology, performs data analysis, investigation, and medical review to detect, prevent, deter, reduce, and make referrals to recover fraud, waste, and abuse.
Since 1999, SGS has prevented more than $7.9 billion in inappropriate payments, consisting of over $5.2 billion in proactively Prevented Dollars and $2.7 billion in Recovered Dollars. Our experience with fraud and abuse analytics has resulted in the referral of hundreds of cases to law enforcement and resulted in successful criminal and civil prosecution and civil monetary penalties.

Experience and Education:

Experience practicing medicine for at least three (3) years as a board-certified doctor of medicine or doctor of osteopathy who is currently licensed to practice in the United States.

•Prior work experience in the health insurance industry, a utilization review firm, or another health care claims processing organizations in a role that involved developing coverage or medical necessity policies and guidelines.
•Extensive knowledge of the Medicare program, particularly the coverage and payment rules and clinical review judgment experience.
•Public relations experience such as working with physician groups, beneficiary organizations, and/or congressional offices is preferred.
•CMS anticipates the Medical Director will be actively engaged in medical review activities such as: issue resolutions, meetings, and other medical review activities.
•See IOM, 100-8, for further Medical Director Requirements.

Requisition ID 1644998