Lecturer Hourly (MD) - Department of Medicine, Medicaid Advisory Unit

University of Illinois Chicago•Chicago, IL

8d•Onsite

About The Position

The UIC DOM MAU is partnering with the University of Illinois' Office of Medicaid Innovation (OMI) to provide clinical and policy expertise to the Illinois Department of Healthcare and Family Services (HFS) Medicaid program. This unit will support the development of state Medicaid policy for new and emerging medical practices and will offer coordinated clinical review for broad as well as specific clinical programs. The program will coordinate the provision of clinician expertise to OMI and HFS to support current and future prior approval and utilization review activities. The Lecturer Hourly will serve as a clinical consultant and physician reviewer for the Medicaid Advisory Unit's Gender Affirming Surgical Care Program, providing independent physician expertise to support policy development, medical necessity/prior authorization review Medicaid beneficiaries seeking gender affirming care services. This position plays a key role in ensuring objective clinical determinations, particularly for cases involving Medicaid recipients who receive care from UIC providers, helping to mitigate potential conflicts of interest while supporting compliance with established program requirements, prior authorization standards, and evidence-based clinical practices.

Requirements

MD from an accredited institution
An active Illinois Medical License

Nice To Haves

Currently enrolled in an accredited Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) program.
Demonstrated ability to conduct research, analyze information, and synthesize findings into concise written materials.

Responsibilities

Review prior authorization, medical necessity, and utilization review of Medicaid beneficiary services for Gender Affirming Surgical Care, pursuant to HFS policy and prior authorization standards.
Assist in the development of key policy points related to Gender Affirming Surgical Care for Medicaid beneficiaries. This might include developing recommendations for service guidelines, such as initial and ongoing eligibility criteria, which may be utilized by HFS for Gender Affirming Surgical Care policy.
Provide, as requested by HFS, testimony and documentation in response to customer appeals and other due process activities when a clinical recommendation results in an adverse outcome.
Maintain sufficient documentation on case reviews to support the findings and outcomes resulting in recommendations to approve or deny customers seeking Gender Affirming Surgical Care service.
Deliver services within the proposed scope of work, in a manner consistent with established timelines and milestones.
Other projects directed by the MAU may also be assigned.
Perform other related duties and participate in special projects as assigned.