3 days old

Medical Director - Medicare

Camp Hill, PA 17011
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Business Group Highlights

Risk Decision

The Risk Decision group is a mission-critical provider of specialized investigative services to a broad range of organizations spanning the federal, intelligence and civilian sectors. Leveraging a nationwide footprint of highly experienced investigators and subject matter experts, we provide critical information to support sensitive decisions.


Responsibilities

Every day at Perspecta, we enable hundreds of thousands of people to take on our nations most important work. Were a company founded on a diverse set of capabilities and skills, bound together by a single promise: we never stop solving our nations most complex challenges. Our team of engineers, analysts, developers, investigators, integrators and architects work tirelessly to create innovative solutions. We continually push ourselvesto respond, to adapt, to go further. To look ahead to the changing landscape and develop new and innovative ways to serve our customers. Perspecta works with U.S. government customers in defense, intelligence, civilian, health care, and state and local markets. Our high-caliber employees are rewarded in many waysnot only through competitive salaries and benefits packages, but the opportunity to create a meaningful impact in jobs and on projects that matter. Perspectas talented and robust workforce14,000 strongstands ready to welcome you to the team. Lets make an impact together.

SafeGuard Services (SGS), a subsidiary of Enterprise Services, 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 preventedmore than$9.3 billion in inappropriate payments,consisting of over $5.8billion in proactively Prevented Dollars and $3.5 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.


Qualifications

The Medical Director must possess: Work Experience

Prior work experience in the health insurance industry, a utilization review firm, or another health care claims processing organization 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. Extensive knowledge of managed care policies and procedures.

Public relations experience such as working with physician groups, beneficiary organizations, and/or congressional offices is preferred.

Must have practiced medicine for at least three (3) years as a board-certified doctor of medicine or doctor of Osteopathic medicine.

Educational Requirements

Must be a board-certified Doctor of Medicine or Doctor of Osteopathic medicine. Degree must be obtained from an accredited institution. The Medical Director must have been board certified for at least three (3) years. All clinicians employed or retained as consultants must also be currently licensed to practice medicine in at least one U.S. state, territory, or the District of Columbia. The contractor shall ensure that the Medical Director and other physician consultants have active valid and unrestricted licenses.


About Perspecta

What matters to our nation, is what matters to us. At Perspecta, everything we do, from conducting innovative research to cultivating strong relationships, supports one imperative: ensuring that your work succeeds. Our company was formed to bring a broad array of capabilities to all parts of the public sectorfrom investigative services and IT strategy to systems work and next-generation engineering.

Our promise is simple: never stop solving our nations most complex challenges. And with a workforce of approximately 14,000, more than 48 percent of which is cleared, we have been trusted to do just that, as a partner of choice across the entire sector.

Perspecta is anAA/EEOEmployer - Minorities/Women/Veterans/Disabled and other protected categories.

As a government contractor, Perspecta abides by the following provision

Pay Transparency Nondiscrimination Provision

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of the other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractors legal duty to furnish information. 41 CFR 60-1.35(c).

Industry

  • Information Technology
Posted: 2020-07-05 Expires: 2020-08-03

With offerings in mission services, digital transformation and enterprise operations, our team of 14,000 engineers, analysts, investigators and architects work tirelessly to create innovative solutions. We have the expertise and experience not only to devise solutions, but to execute on them successfully.

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Medical Director - Medicare

Perspecta
Camp Hill, PA 17011

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