Products / Services
Competition Number:
2012-749
Competition Dates - From: 
Friday, March 22, 2013
To: 
Monday, April 08, 2013
Title:
Medical Consultant
Location:
Dartmouth, NS
Employment Type:
Consultant Position - 3 year contract
Salary:
Competitive Compensation
Description:

“To help improve the health and well-being of people and their communities.”

Recognized as one of Canada’s 10 Most Admired Corporate Cultures, Medavie Blue Cross understands each one of its 1,900 employees plays a key role in building a strong and successful organization. Throughout the six provinces in which we operate, we know our people make a difference in our customers’ lives each day.  We encourage our employees to be involved and to support activities that allow for personal and professional growth and development. As a not-for-profit organization, we also place a high priority on giving back to the communities in which we live.

If you are looking for an opportunity in a challenging, fast-paced and team-oriented work environment with a leading local organization, the career you’ve been looking for may be waiting for you at Medavie Blue Cross.

Role Summary:
We are currently accepting applications for a part time Medical Consultant.  The successful candidate will work onsite with the MSI Program’s team in our Dartmouth office and will be responsible for providing professional medical guidance in support of the MSI claims adjudication system.  In this role, the successful candidate will be responsible for providing a professional link between physicians, government and patients.
As a Medical Consultant, your key responsibilities will include:
  • Providing direction and guidance to the Claims Assessment team regarding claims adjudication and payment.
  • Reviewing requests for pre-authorization of in-province physician services; out-of-province/country
  • physician services or hospitalization and retroactive payment of out-of-province/country physician services or hospitalization claims.
  • Ensuring all administrative processes are followed for out-of-province/country referrals for addiction and mental health services. 
  • Providing or assisting in the first level of appeals for citizen/provider complaints regarding issues of medical insurability, medical necessity and treatment not normally insured as well as provider appeals regarding claims payment.
  • Providing assistance to the Department of Health and Wellness Medical Consultant to support medical policy, medical tariff development and activities related to claims assessment; and
  • Responding to enquiries from patients, physicians, Doctors NS, Nova Scotia College of Physicians and Surgeons, Medical Directors and the Department of Health and Wellness with respect to individual patient claims and the insurability of specific services for an individual according to Department of Health and Wellness policy.
As the ideal candidate, you possess the following qualifications:

Education:    University degree with a Doctorate in Medicine.

Work Experience:   Ten to 15 years experience as a physician in a range of practice settings. Surgical and administrative experience would be an asset.

Other Qualifications:   Strong interpersonal skills and the ability to resolve conflicts and deal with stressful situations.

Computer SkillsGeneral computer knowledge.

Communication Skills:  Excellent written and verbal communication skills are fundamental to the position.

You also demonstrate the following core competencies:

Knowledge:  Uses knowledge and industry best practices to provide guidance and/or advice to managers and co-workers 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.

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 any one on one situation.

Customer Orientation:  Independently processes many unusual and demanding customer requests. Maintains library/database/network of all customer information and materials to meet both routine and complex customer needs.

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

Team Work
:  Provides professional advice and direction to team members and leads work processes and proactively searches for ways to improve team effectiveness and performance.

If you are interested in working with a team of professionals in a challenging role and you possess the necessary qualifications, please follow the instructions for applying on-line via the Medavie Blue Cross corporate website by clicking on the link below.

 

Apply Now

We would like to thank all candidates for expressing interest. Please note only those selected for interviews will be contacted. No phone calls please.

Citizenship - Useful Information

Please indicate in your application the reason you are entitled to work in Canada: Canadian citizenship, permanent resident status or work permit.

Reliability screening will be required.

Medavie Blue Cross is an equal opportunity employer.