Supplemental Benefits Medical Director (Physician Reviewer) | Remote | Contract to Hire Position Available In Davidson, Tennessee

Supplemental Benefits Medical Director (Physician Reviewer) | Remote | Contract to Hire
Business & Care Management Nashville, Tennessee
Contract-to-Hire
May 15, 2025
Supplemental Benefits Medical Director |10+ year’s | Remote | Contract Walker Healthforce is seeking a Supplemental Benefits Medical Director with 10+ years’ experience to support a healthcare client based out of Nashville, TN. This is a 6-month contract opportunity.

START DATE

ASAP

CORE REQUIREMENTS

The Medical Director will be a Board-certified physician with current unrestricted medical license
Minimum of 10-years of clinical practice experience. Candidates must be able to obtain medical license and other state licenses as needed.
Preferentially we need an Internal Medicine, Geriatric, or Family practitioner with computer experience, presentation experience, case management experience, and appeal review experience.
Board Certification/ABMS is required for the role.
Position is remote but looking for candidates to be located near the following areas:
Nashville, TN
Huntsville, Birmingham and/or Mobile, AL
Houston, TX

WE CONSIDER IT A BONUS IF YOU ALSO HAVE

Experience in Medigap, Supplemental Health Insurance, and Medical Underwriting is preferred.
MBA or equivalent experience preferred

JOB RESPONSIBILITIES

Supplemental Benefits Medical Director provides peace-of-mind and financial security for more than 800,000 policyholders of all ages through Medicare Supplement and Supplemental Health and Life (SHL) products. Our environment is fast paced, the work is meaningful and intense, and our performance expectations are high. The ideal candidate will leverage their extensive clinical experience to enable delivery of clients market-leading strategies, improving the lives of the individuals we serve. The Medical Director will work closely with National Medical Director and leadership to identify opportunities to manage and improve clinical reviews and processes, deploy new innovations, and collaboratively engage clinical expertise across the Enterprise.

Key Job Functions:

Provides clinical expertise and support for all departments and divisions related to clients Medicare Supplement (Medigap) and Individual Supplemental Health and Life (SHL) Insurance products, including but not limited to, Underwriting, Legal, Marketing, Operations, Product, and Claims.
Has clinical responsibility for helping to ensure the strategic and tactical delivery of project work for the clients Supplemental Health products in forty-nine states and the District of Columbia (DC).
Provides clinical resources and education to a multi-disciplinary team of nonclinical staff for Supplemental Benefits, responsible for supporting Medigap underwriters in all aspects of the underwriting process, assists SHL Claims Representatives with complex claims consults, appeals and reviews, rescissions, as well as fraud and abuse cases.
Oversees the Supplemental Benefits Clinical Team (SBCT), which is a multifunctional team that includes Medical Directors, pharmacist(s), data analyst(s), and other ad hoc members as needed from across the Enterprise.
Works closely with the actuarial team for the clinical integrity of various undertakings, involving underwriting, pricing, claims automation, and cost analysis.
Responsible for clinical input to the development of new innovative tactics and methodologies to improve cost containment for Medigap and SHL products, such as Preventive Care, vendor solutions, and other medical management initiatives.

WHAT WE OFFER

Competitive compensation package
Weekly pay via Direct Deposit
Medical, Dental & Vision available
401k options

WHY WORK WITH WALKER?

Access to our top ranked team of recruiting and placement specialists
Continuous, one-on-one support from a dedicated engagement manager
Professional resume development and interview preparation Contact our Recruiting Team today to experience the Walker Healthforce difference!

ABOUT US

Walker Healthforce is known as the dominant force of performance, precision, expertise, and integrity in the healthcare consulting community! As a certified WMBE, we provide end-to-end healthcare IT and clinical solutions to hospitals, health systems, and payer organizations, including Fortune 100 firms nationwide. We are healthcare experts, we’re custom not commodity and we’ve been exceeding expectations for nearly 20 years. Join forces with us to experience unparalleled results today! We are an Equal Opportunity Employer committed to a culturally diverse workforce. All qualified applicants will receive consideration for employment without regard to race, religion, color, age, sex, national origin, sexual orientation, gender identity, disability status or protected veteran status.