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Medical Consultant

Posting Date: Nov 17, 2021

Location: Dartmouth, Nova Scotia, CA, B3J 3C6

Company: Medavie Blue Cross

Job Title: Medical Consultant 
Department: Medicare Programs 
Internal/External: Internal/ External
Employment Type: External Consultant - Part-time hours initially, gradually increasing to Full-time hours 
Location: Dartmouth
Salary: Competitive Compensation
Reports To: Team Leader
Closing Date: December 15, 2021



Role Summary:
We are currently accepting applications for an external Medical Consultant to join the Medicare Programs Team. The successful candidate will work with the Medicare Programs Team and will be responsible for supporting the MSI post-payment monitoring function. The Medical Consultant will provide the medical link between paying agency and providers. In collaboration with the MSI Audit Team, they also will advise the key stakeholders of Medavie Blue Cross and the Department of Health and Wellness of Nova Scotia on MSI Monitoring related matters including the development of policies and procedures.


This opportunity will be Part-time hours initially, gradually increasing to Full-time hours.


As a MSI Monitoring Medical Consultant, your key responsibilities will include:
•    Conduct fee for service and shadow billing audits in collaboration with the Medicare Auditors.
•    Support the evaluation of select alternative funding contracts, includes interviews with providers and other parties.
•    Assist in the development of the annual audit plan, procedures to enhance monitoring operations.
•    Participate and provide feedback into the development of risk analysis strategies to utilize departmental resources efficiently.
•    Communicate with providers, Nova Scotia residents, Department of Health and Wellness, Doctors Nova Scotia, law enforcement, other government agencies in relation to MSI audit.
•    Provide feedback and billing guidance to physicians in relation to billing audit results.
•    Participate in various meetings with the Department of Health and Wellness and other stakeholders as required.
•    Resolve issues and maintain productive, professional relationships with medical provider community and Department of Health and Wellness; inform providers through MSI Physician Bulletin publications of changing audit policies, administrative procedures, and billing issues.
•    Liaise with and provide support to staff from other MSI departments including the provision of claims assessment support as required.
•    Provide support to the Nova Scotia Department of Health and Wellness regarding physician appeals of billing audits.
•    Maintain confidentiality, respecting both patients and provider matters.


As the ideal candidate, you possess the following qualifications:

Education: University degree with a Doctor of Medicine with an active medical license in good standing in the current jurisdiction, an active member with the Canadian Medical Protective Association and eligibility for licensure with the College of Physicians and Surgeons of Nova Scotia.


Work Experience: Minimum of 15 years experience as a physician in a range of practice settings. Specialist training and administrative experience would be an asset. 


Computer Skills: General computer knowledge, including functional knowledge of Microsoft Office products (Word, Excel, Power Point) and email.


Communication Skills: Excellent written and verbal communication skills are fundamental to the position. Strong interpersonal skills and the ability to build relationships, mentor and support providers and resolve conflicts. 


Other Qualifications: Ability to travel throughout the province of Nova Scotia.


You also demonstrate the following core competencies:


Knowledge: Uses knowledge and industry best practices to provide guidance and/or advice to practitioners, leaders, and coworkers on key issues in own area of expertise. Demonstrates a specialized knowledge of all processes, policies, and precedents to do the job and solve day to day issues independently. This includes familiarity with safe prescribing guidelines, as well as relevant standards and expectations as outlined by each licensing authority. 


Analytical Thinking: Uses knowledge and experience to solve a variety of routine and complex technical problems. Identifies the cause of problems and implements the most appropriate solution.


Communication: Able to communicate complex information effectively through both oral and written means. Demonstrates the full range of effective verbal communication skills in a variety of settings such as formal meetings, presentations and across disciplines. 


Customer Orientation: Able to support, mentor and guide practitioners even when their viewpoint may be different than your own.


Execution and Organizational Skills: Exceptional organizational and time-management skills. Able to prioritize work within a changing work environment under the pressure of deadlines. 


Teamwork: Provides professional advice and support to team members, proactively searches for ways to improve work effectiveness and performance. 


We would like to thank all candidates for expressing interest.  Please note only those selected for interviews will be contacted.

Medavie Blue Cross is an equal opportunity employer.

In order to keep our employees, candidates, and community safe during the COVID-19 pandemic, the majority of our employees are working from home within Canada. All interviewing, onboarding and most work takes place remotely at this time. For those employees who must work in our offices, we have taken every precaution to ensure the health and safety of our people by providing strict protocols/practices to meet legislated client and company needs, as well as modifications to the worksites to mitigate the risks for everyone's protection.

At Medavie, everything we do is to improve the wellbeing of Canadians.  We have implemented a COVID-19 Vaccination Policy as part of our ongoing efforts to protect the health and safety of our employees, partners, plan members and the communities where we live and work.  Proof of full vaccination is required to work onsite at any Medavie Workspace. 

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