Contractor Medical Director

*** This position is contingent upon a federal contract award. ***

Location: Remote (U.S.-based)
Position Type: Part-Time or Full-Time Consultant, Key Personnel (one or more positions may be filled)
Clearance: Ability to obtain CMS data access approvals

Position Overview

We are seeking one or more Contractor Medical Director(s) to provide senior clinical leadership in support of the End Stage Renal Disease Prospective Payment System (ESRD PPS) and the Acute Kidney Injury Payment System (AKI PS) . This role ensures that all policy, analytic, and payment recommendations are firmly grounded in current nephrology practice, clinical evidence, and real-world patient care considerations .

The Contractor Medical Director serves as a trusted clinical advisor to the Centers for Medicare & Medicaid Services (CMS), policy leads, and analytic teams—evaluating the clinical appropriateness and potential patient impact of proposed ESRD PPS and AKI payment modifications.

Key Responsibilities

• Provide clinical expertise and oversight to ensure ESRD PPS and AKI policy recommendations reflect evidence-based nephrology practice.
• Advise on the clinical implications of proposed payment model changes , including effects on patient access, quality of care, and clinical outcomes.
• Support evaluation of dialysis modalities, procedures, technologies, and pharmaceutical interventions relevant to ESRD and AKI populations.
• Review and interpret analytic findings from a clinical perspective and provide guidance on appropriate policy options.
• Advise on clinical considerations related to TDAPA, TPNIES, outlier policy, pediatric ESRD payment, and home dialysis initiatives .
• Participate in CMS briefings, meetings, and technical discussions as needed, including rulemaking support activities.
• Support responses to stakeholder comments by providing clinically grounded explanations suitable for Federal Register documentation.
• Collaborate closely with the Project Director, Payment Analysis Lead, and Data Analytics Lead to ensure alignment between clinical practice, analytics, and policy.

Minimum Qualifications

• M.D. or D.O. from an accredited medical institution.
• Board certification in Nephrology , held for at least 3 years .
• Active, unrestricted license to practice medicine in at least one U.S. state, territory, or the District of Columbia.
• Must never have been sanctioned or excluded from participation in the Medicare Program.
• Minimum 5 years of clinical nephrology practice , with demonstrated expertise in both adult and pediatric ESRD patient populations .
• Strong knowledge of:
  • Dialysis procedures and modalities
  • Innovative dialysis technologies and equipment
  • Pharmaceuticals and biological products relevant to kidney disease and dialysis care

Preferred Qualifications

• Direct advisory experience to CMS or state Medicaid programs on dialysis or kidney disease policy.
• Active involvement in clinical research , policy advisory boards, technical expert panels (TEPs), or technology assessment panels related to kidney disease.
• Understanding of transplant medicine and its integration with dialysis care and payment policy.
• Experience communicating clinical concepts to policy, analytic, and non-clinical audiences.

Why This Role Matters

The Contractor Medical Director plays a vital role in ensuring that national dialysis payment policy supports safe, effective, and patient-centered care . Clinical insight from practicing nephrologists is essential to balancing payment accuracy with real-world care delivery for ESRD and AKI patients across the Medicare program.