Research Medical Director

The Research Medical Director is a pivotal member within Cotiviti's Clinical and Policy research development area. This role is responsible for offering leadership to the clinical teams, verifying the precise interpretation and development of the Rules and policies. You will be analyzing, interpreting, and evolving additional policies, enhancing the medical policy library, and guiding both internal and external processes related to policies and rules. Key responsibilities include interpreting payment policy and medical coding information, conducting thorough research, performing multi-faceted analytics, translating industry references into Cotiviti policy, reviewing medical policies to maintain accuracy, identifying new opportunities, and analyzing research inquiries to determine potential impact on medical policies. This position requires the ability to determine when policy updates are needed and to provide QA of policy reviews to ensure accuracy. The director will also actively participate in meetings, educating client-facing professionals on policy changes.