HEALTHCARE CLINICAL EVALUATOR SR PRINCIPAL

Solve real-world challenges that impact the frontlines of public health, life science, and clinical research initiatives as a Healthcare Clinical Evaluator SME at GDIT. You’ll support the mission and grow with it, building a meaningful career in health.

MEANINGFUL WORK AND PERSONAL IMPACT
As a Healthcare Clinical Evaluator SME, the work you’ll do at GDIT will be impactful to the mission of MD Healthcare Consultant. You will play a crucial role in reviewing prior authorizations (PAs) under the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program. You will be trusted to adjudicate PDN and DME prior approval requests to determine if the request is deemed medically necessary.
● Support teams by reviewing PAs in a timely manner, meeting all guidelines set by our customers
● Collaborate with the Medical Director, Physical Therapy, Nurses, and other staff to complete PA request
● Collaborating with North Carolina Medicaid on PDN and DME cases

● Drive success by managing incoming PAs and meeting all service level agreements
● Utilize medical knowledge

●Your success will be measured through the delivery of quality prior approval reviews defined by service level agreements

WHAT YOU’LL NEED TO SUCCEED
Bring your health discipline expertise and drive for innovation to GDIT. The Healthcare Clinical Evaluator SME must have:
● Education: MD/DO
● Experience: 15+ years of related experience
● Technical skills: Microsoft products, Adobe PDF


GDIT IS YOUR PLACE
At GDIT, the mission is our purpose, and our people are at the center of everything we do.
● Growth: AI-powered career tool that identifies career steps and learning opportunities
● Support: An internal mobility team focused on helping you achieve your career goals
● Rewards: Comprehensive benefits and wellness packages, 401K with company match, and competitive pay and paid time off
● Flexibility: Full-flex work week to own your priorities at work and at home ***remove if ineligible***
● Community: Award-winning culture of innovation and a military-friendly workplace

OWN YOUR OPPORTUNITY
Explore a career in health at GDIT and you’ll find endless opportunities to grow alongside colleagues who share your sense of purpose for making a difference.