Medical Director (Remote)

Randstad (Schweiz) AG; Tennessee; Remote; USD 200,000 - 300,000; Full time

Job summary

A leading company is seeking a Medical Director to enhance clinical review processes and implement innovations in Medicare Supplement products. The role requires a board-certified physician with extensive experience and strong analytical and communication skills. This position offers the opportunity to lead a clinical team and make significant impacts across the organization.

Qualifications

• Board-certified physician with active medical license.
• At least 10 years of clinical practice experience.
• Ability to obtain licenses in required states.

Responsibilities

• Provide clinical expertise related to Medicare Supplement products.
• Oversee the Supplemental Benefits Clinical Team.
• Collaborate with actuarial team on underwriting and pricing.

Skills

Analytical skills

Decision-making skills

Problem-solving skills

Communication skills

Negotiation skills

Conflict management skills

Computer skills

Data science background

Presentation skills

Education

Board-certified physician

MBA or similar experience

Job description

We're Hiring: Medical Director! Open to candidates in IL, TX, NM, OK, MT, TN, and AL.

Work Schedule: M-F, up to 40 hours per week (minimum 32 hours).

Preferred Qualifications: Internal Medicine, Geriatric, or Family Practice background with experience in computer applications, presentations, case management, and appeal reviews.

Job Title: Cigna Supplemental Benefits (CSB) Medical Director

Job Summary:

The CSB Medical Director collaborates with the National Medical Director and CSB leadership to enhance clinical review processes, implement innovations, and leverage clinical expertise across the enterprise.

Key Job Functions:

1. Provide clinical expertise across departments related to Medicare Supplement (Medigap) and Supplemental Health and Life (SHL) products, including underwriting, legal, marketing, operations, and claims.
2. Ensure strategic and tactical delivery of projects for supplemental health products across 49 states and DC.
3. Support Medigap underwriters, assist claims with complex cases, appeals, rescissions, and fraud/abuse cases.
4. Oversee the Supplemental Benefits Clinical Team, including Medical Directors, pharmacists, data analysts, and other specialists.
5. Collaborate with actuarial team on underwriting, pricing, claims automation, and cost analysis.
6. Contribute clinical insights to develop new cost-containment strategies and medical management initiatives.

Minimum Qualifications:

Education & Experience: Board-certified physician with an active, unrestricted medical license and at least 10 years of clinical practice. Ability to obtain licenses in required states.

Competencies & Skills:

• Experience with Medigap, Supplemental Health Insurance, and Medical Underwriting preferred.
• MBA or similar experience preferred.
• Strong analytical, decision-making, and problem-solving skills.
• Excellent communication, negotiation, and conflict management abilities.
• Proficiency in computer skills; data science background is a plus.
• Experience in developing professional presentations for diverse audiences.
• Ability to work independently under pressure and foster collaborative relationships.

Ready to make an impact? Apply now and let’s grow together!