AI Summary & Insights Summary Insights Senior Medical Director/Clinical Educator The insights provided are generated by AI and may contain inaccuracies. Please independently verify any critical information before relying on it. Senior Medical Director/Clinical Educator The insights provided are generated by AI and may contain inaccuracies. Please independently verify any critical information before relying on it. Description Senior Medical Director/Clinical Educator Remote 10-15 hrs/week 1099 Flexible Hours PayerWatch and the Association for Healthcare Denial & Appeal Management (AHDAM) are seeking a part-time physician leader focused on provider and patient advocacy, training and education. It's partly a public-facing role: developing and presenting denial and appeal webinars and content for other healthcare advocates. This physician reports directly to the Chief Medical Officer/Chief AI Officer and the Chief Executive Officer, continuing the delivery of advocacy, training, appeal certification and appeal expertise to the AHDAM community of 1,800+ hospital and health system professionals. In practice that means shaping the webinar calendar, presenting, and maintaining the AHDAM certification material.

Requirements Who fits:

MD or DO heavily involved in denial and appeal management on the provider side: physician advisor, utilization review, care management. You know what a clean med nec argument looks like, you understand the Two-Midnight rule, Condition Code 44 and MA plan obligations, and you can tell a winnable appeal from a case where provider education would prevent the next denial. Prior appeal writing and appeal program management preferred, along with an understanding of escalation strategies and how to construct a successful peer-to-peer. You can teach, and you like it. You can run a webinar people actually learn from, and turn dense regulatory material into something a working professional can use. You don't need to code or engineer prompts. Some curiosity or cursory knowledge of AI is helpful, along with a willingness to teach others to work with it, because our education increasingly covers it. If this sounds like your kind of work, send a note about what you've done lately: your experience, the education you've built, and any AI exposure. If it isn't for you, please pass it along to an interested colleague.