Washington Licensed Medical Director

A company is looking for an Internist, ABIM / AOBIM Medical Director to conduct outpatient prior authorizations and ensure compliance with clinical guidelines.

Key Responsibilities :

Conduct regular reviews of care provided to beneficiaries and recommend necessary adjustments to align with CMS guidelines

Assist in training clinical teams on CMS guidelines and compliance

Provide recommendations for improving clinical practices based on data analysis and best practices

Required Qualifications :

Board-certified clinician (Doctor of Medicine or Doctor of Osteopathy) with at least 3 years of certification

Active, valid, and unrestricted medical license in at least one U.S. state

Familiarity with outpatient internal medicine and related specialties

Utilization management experience preferred

Willingness to obtain a Washington state medical license preferred