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Medical Consultant

2 months ago

Dartmouth, Canada Medavie Blue Cross Full time
Job Title: Medical Consultant

Medavie Blue Cross is seeking a highly skilled Medical Consultant to join our Medicare Programs Team on a part-time basis. As a Medical Consultant, you will play a critical role in supporting the MSI post-payment monitoring function and providing medical expertise to key stakeholders.

Key Responsibilities:
  • Support a team of Medicare Auditors in conducting billing audits and evaluating alternative funding contracts.
  • Develop and implement policies and procedures to enhance monitoring operations and risk analysis strategies.
  • Communicate with providers, Nova Scotia residents, and government agencies to resolve issues and maintain productive relationships.
  • Provide feedback and billing guidance to the audit team and physicians on audit results.
  • Liaise with and support staff from other MSI departments, including claims assessment and physician appeals.
Requirements:
  • University degree with a Doctor of Medicine and an active medical license in good standing.
  • 10-15 years' experience as a physician in a range of practice settings, with specialist training and administrative experience an asset.
  • Excellent written and verbal communication skills, with strong interpersonal skills and ability to build relationships.
  • Ability to travel throughout the province of Nova Scotia.
Core Competencies:
  • Knowledge: Uses knowledge and industry best practices to provide guidance and advice on key issues in own area of expertise.
  • Analytical Thinking: Uses knowledge and experience to solve routine and complex technical problems.
  • Communication: Communicates complex information effectively through oral and written means.
  • Customer Orientation: Supports, mentors, and guides practitioners even when their viewpoint may be different than your own.
  • Execution and Organizational Skills: Exceptional organizational and time-management skills, with ability to prioritize work under pressure.
  • Teamwork: Provides professional advice and support to team members, proactively searching for ways to improve work effectiveness and performance.