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Medical Principal – Gastroenterologist

PrincipalGeneralFull TimeRemoteLeadTeam 10,001+Since 1982H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

10 days ago

Salary

$212.6K - $354.3K / year

Seniority

Lead

Postgraduate Degree5 yrs expEnglish

Job Description

Medical Principal – Gastroenterologist

The Cigna Group

• A Medical Principal performs medical review and case management activities. • Provides clinical insight to the organization through peer review, benefit review, consultation, and service to internal and external customers. • Serves as a clinical educator and consultant to utilization management, case management, network, contracting, pharmacy, and service operations (claims). • Performs benefit-driven medical necessity reviews for coverage, case management, and claims resolution, using benefit plan information, applicable federal and state regulations, clinical guidelines, and best practice principles. • Works to achieve quality outcomes for customers/members with a focus on service and cost. • Improves clinical outcomes through daily interactions with health care professionals using active listening, education, and excellent communication and negotiation skills.

Job Requirements

  • Current unrestricted medical license in a US state or territory.
  • Current board certification (lifetime certification or certification maintained by MOC or other applicable program) in an ABMS or AOA recognized specialty (Gastroenterology)
  • Minimum of 5 years of clinical practice experience and/or direct patient care beyond residency.
  • Computer Competency: Word processing, Spreadsheet, Email, PowerPoint and Personal Information Management programs are used extensively and competency in all must be possessed or rapidly acquired.
  • Must not be excluded from participation in any federal health care program.
  • Must not be included in CMS’ Preclusion List.

Benefits

  • medical, vision, dental, and well-being and behavioral health programs
  • 401(k)
  • company paid life insurance
  • tuition reimbursement
  • a minimum of 18 days of paid time off per year
  • paid holidays
  • leaves of absence

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