Remote Research Medical Director, Medicaid Policy

COTIVITI, INC.; South Jordan (UT); Remote; USD 180,000 - 240,000; Full time

Job summary

Cotiviti is seeking a Research Medical Director (Medicaid Medical Policy) to lead clinical policy interpretation and development for our payment policy library. This remote US role requires guiding clinical teams, performing in-depth research, and translating industry references into Cotiviti policy.

The position emphasizes leadership, strategic policy analysis, and collaboration with client-facing teams to ensure accurate and current medical policy rules.

Qualifications

• 10+ years of research experience in healthcare policy or related field.
• Experience with Medicaid payer policies or adjudication is preferred.
• Strong leadership and project management capabilities.

Responsibilities

• Lead interpretation and development of payment policy and medical coding rules.
• Conduct research and analysis to expand the medical policy library.
• Provide QA and guidance to clinical teams and client-facing MDs/CPMs on policy updates.
• Educate clients on policy changes in monthly meetings with stakeholders.
• Maintain up-to-date knowledge of industry best practices and policies.

Skills

Research experience

Medicaid payer experience

Education

MD/DO

MBA

Job description

Cotiviti is seeking a Research Medical Director (Medicaid Medical Policy) to lead clinical policy interpretation and development for our payment policy library. This remote US role requires guiding clinical teams, performing in-depth research, and translating industry references into Cotiviti policy.

The position emphasizes leadership, strategic policy analysis, and collaboration with client-facing teams to ensure accurate and current medical policy rules.