Medical Policy Specialist jobs in South Bend, IN

Position Type: Full-time, exempt

Compensation: Up to $400,000 annually monthly Medical Director Stipend

Job Location: In person

Job Highlights

• Work-Life Balance: Competitive compensation with balanced hours.
• Weekend & On-Call Freedom: No on-call, no weekends.
• Always Supported: NP/PA support at all locations, always.
• Pre-Screened Patient Interactions: Telemedicine and APP triage before physician contact.
• Flexible Scheduling: Your schedule, tailored to fit your life. No set daily shift times.
• No Overnight Duties: Sleep peacefully with no overnight call/requirements.
• Effortless documentation: Conversational and Dragon dictation.
• Meaningful Connections: Establish lasting relationships with patients and staff.
• Culture of Appreciation: Your work is valued and rewarded.
• $1,500 CME and Conference Allowance: Invest in your growth.
• Full Gear: iPad with LTE, Apple Pen, AirPods provided.
• Licensure Reimbursed: We cover your medical licensure costs.
• Malpractice & Tail Covered: Full insurance peace of mind.
• Benefits: 401k match, Medical/Dental/Vision, Disability, Employer-paid Life Insurance.
• Relocation Help: Assistance for a smooth move.
• Referral Bonus: Earn more by expanding our team.
• Travel Reimbursed: Gas and mileage for work travel.
• Career Advancement: Leadership opportunities promoted.
• UpToDate Subscription: Latest medical info at your fingertips.

Essential Functions & Responsibilities

• The physician serves as medical director for skilled nursing facilities (SNF) and participates in administrative and quality initiatives for the facilities he or she is responsible for;
• Medical directorship functions include attending and participating in monthly quality assurance and process improvement meetings; participating in quality improvement initiatives; providing guidance to facility staff; reviewing and revising (if necessary) facility’s clinical guidelines; insuring compliance with state and federal regulations, training facility staff; and supervising facility clinical staff.
• In addition to the medical director role, the physician also serves as the attending physician for the residents residing at each facility;
• The physician collaborates with Nurse Practitioners and Physician Assistants to manage day to day resident care at each facility. Typically, each facility will have a full-time PA or NP assigned to the facility depending on the acuity and volume of the patient population;
• Physician will provide high quality, patient-centered, comprehensive primary care services by rounding on patients residing in SNFs;
• Physician is responsible for diagnosing and treating patients with acute illness, such as bacterial and viral infections, as well as chronic diseases and conditions, such as hypertension, heart disease, or diabetes
• Provider documentation is completed in Theoria’s proprietary electronic health record (EHR) system, ChartEasy™
• PointClickCare, MatrixCare, and American HealthTech are the most commonly used facility EHR systems
• Participating in Theoria’s Chronic Care Management, Transitional Care, RPM and other medical quality initiatives and programs
• Physician must be able to supervise collaborating nurse practitioners and physicians assistants
• Physician must be able to utilize electronic/online medical tools such as EHR systems and state/county medical systems utilized for Death Certificates and administrative functions.

Company Overview

Leading the charge in healthcare innovation, Theoria Medical offers a unique blend of medical excellence and technological advancement, primarily serving the post-acute and primary care sectors. Our extensive network includes multispecialty physician services, telemedicine, and RPM, covering skilled nursing facilities across the country. In our national push for expansion, we're scouting for the brightest nurse practitioners and physicians eager to drive change and deliver superior care. Join us for a rewarding career that promises professional growth, flexibility, and the chance to shape the future of healthcare.

Shift Structure

• Shifts are flexible depending on physicians’ schedule;
• Typically, medical directors work a minimum of 2-3 days/week at each facility they oversee;
• Rounding times are flexible with no set start and end time. Preferably, physicians start in the morning between 7-10 a.m. and finish their day when their caseload has been seen;
• No nights, weekends, or on-call
• Call is covered by Theoria’s telemedicine team
• This is an in-person position

Compensation and Benefits

• Competitive compensation package, including Medical Director stipend
• Compensation ranges approximately from $50,000-$400,000/year depending upon employment status and availability (PRN, Part-Time, Full-Time)
• Employer Paid - Life Insurance Policy

Employee must be able to perform the essential functions of this position satisfactorily, with or without a reasonable accommodation. Employer retains the right to change or assign other duties to this position. All benefits and job highlights are subject to and contingent upon availability.

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