Medical Director (MD/DO)
Location: Jacksonville, FL
Job Type: Direct Placement
Company: ARC Group
Category: Administration
Job Description Apply Now
The Medical Director (MD/DO) plays a pivotal leadership role in overseeing clinical activities, policy development, and quality assurance within a Medicare Administrative Contractor (MAC) environment. This full-time, remote position is designed for a physician with a strong background in clinical practice and extensive knowledge of Medicare coverage and payment policies. As a key liaison between the Centers for Medicare & Medicaid Services (CMS), the organization, and external stakeholders, the Medical Director ensures that evidence-based decision-making guides all aspects of medical review, claims determination, provider education, and program integrity.
ARC Group, a nationally recognized executive search firm, is committed to fostering a workplace that values diversity, inclusion, and respect for all team members. The organization encourages applicants from all backgrounds and is dedicated to creating an environment where every individual can thrive. The Medical Director (MD/DO) position is a unique opportunity to contribute to the improvement of healthcare delivery, policy compliance, and service quality for millions of beneficiaries.
The Medical Director (MD/DO) will leverage their expertise to collaborate closely with multidisciplinary teams, represent the organization at CMS meetings and industry conferences, and provide strategic direction in developing and updating local coverage determinations (LCDs). The role also requires effective communication and educational outreach to providers, ensuring stakeholders are informed about Medicare policies and regulatory changes. The ideal candidate will possess a current, unrestricted medical license, board certification, and a minimum of three years of clinical experience as an attending physician.
Located remotely and operating on Eastern Time Zone business hours, this role provides the flexibility of remote work while maintaining a high level of engagement with internal staff and external partners. Successful candidates must have permanent US work authorization and be committed to upholding the organization's mission of integrity and service excellence. If you are ready to make a significant impact in the healthcare industry, we invite you to apply for the Medical Director (MD/DO) position by clicking the application button and joining an organization that values your skills and dedication.
Medical Director (MD/DO) - Summary- Full-time, remote leadership role within a Medicare Administrative Contractor (MAC) environment
- Key liaison between CMS, internal teams, and external stakeholders
- Responsible for policy development, clinical oversight, and provider education
- Commitment to diversity, equity, and inclusion in the workplace
- Provide clinical expertise and consultation to the provider/supplier/beneficiary community
- Lead the development, revision, and implementation of Local Coverage Determinations (LCDs)
- Collaborate with CMS and other contractors on medical policy updates and compliance
- Support program integrity by identifying and addressing billing and compliance trends
- Oversee medical review (MR) activities to ensure accurate claim determinations
- Lead and participate in provider education initiatives and communication strategies
- Represent the organization at CMS meetings, industry conferences, and inter-agency collaborations
- Strengthen quality improvement processes, including reviewer reliability reviews
- Participate in the appeal process, including complex case reviews and administrative hearings
- Travel as required for meetings and conferences (estimated 3-4 weeks per year, subject to business needs)
- Competitive salary package commensurate with experience and qualifications
- Comprehensive benefits including health, dental, vision, and retirement plans
- Remote work flexibility with support for work-life balance
- Professional development and continuous learning opportunities
- Commitment to diversity, equity, and inclusion in all employment practices
- MD or DO degree from an accredited medical school
- Minimum of three years of clinical practice experience as an attending physician
- Extensive knowledge of the Medicare program, coverage, and payment rules
- Experience in health insurance, utilization review, or healthcare claims processing
- Expertise in developing evidence-based medical necessity standards and policy
- Basic understanding of medical coding conventions
- Strong communication and collaboration skills with internal and external stakeholders
- Proficiency in public speaking and provider education
- Current, unrestricted license to practice medicine in a US state or territory
- Board Certification in a specialty recognized by the American Board of Medical Specialties
- Eligible for licensure within the organization’s jurisdiction
- Computer literacy, including proficiency in word processing, spreadsheets, presentation, and virtual meeting tools
- Experienced in Medicare policy, medical director roles, or commercial healthcare organizations
- Background in specialties such as Physical Medicine & Rehabilitation, Oncology, Radiology, Ophthalmology, or Infectious Diseases
- Advanced degree (MBA, MHA, MS in Management) or coursework in healthcare management preferred
- Proficient in medical coding (HCPCS, CPT, ICD-10)
- Experience with GRADE methodology and systematic literature reviews
- Demonstrated leadership in organized medicine, committee chair roles, or stakeholder engagement
- ARC Group is ranked as a top 20 recruiting and executive search firm by Forbes
- Position is offered with no fee to the candidate
- Equal Opportunity Employer: Applications from all qualified individuals are encouraged
- Accommodations are available for candidates requiring assistance during the recruitment process
- Permanent US work authorization required; no C2C or third-party candidates considered
If you are an experienced physician ready to take on a leadership position with broad impact, we encourage you to apply for the Medical Director (MD/DO) role today by clicking the application button. Join ARC Group and contribute to advancing healthcare quality, compliance, and innovation nationwide.