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Remote Medicaid Medical Policy Director

Cotiviti USA, LLC

New York, NY
  • Remote job

A healthcare solutions provider is seeking a Research Medical Director responsible for providing leadership in clinical and policy research. This role involves analyzing and developing medical policies as well as interpreting medical coding guidelines. Candidates should possess an MD or DO degree with a strong background in research and project management. This position offers a competitive salary and the possibility of remote work from the United States. #J-18808-Ljbffr Cotiviti

Vacancy posted 2 days ago
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