MEDI-7903 - USA (Waterbury, Virgin Islands) - Medicaid Physician Review and Consulting Services - Deadline July 10,2027

(1) Vendor needs to provide medicaid physician review and consulting services to the government authority located in Waterbury, VI. – Provide medical oversight related to the clinical needs of the department, provide prior authorization case review and medical necessity determinations in a medicaid managed care environment.– Competencies, knowledge, skills and abilities experience and subject matter expertise.– Communication skills excellent verbal and written communication skills.– Analytical skills advanced ability to analyze clinical data from medical, mental health, and pharmacy claims, medical records, national guidelines, peer reviewed literature, and medical policies.– Interpersonal skills advanced ability to build effective relationships (within company, within broader community), work effectively in a team–based environment, motivate, build consensus, negotiate, persuade, facilitate, resolve conflicts, demonstrate tact/sensitivity, and observe confidentiality.