Hawaii Licensed Medical Director

A company is looking for a Medical Director - Clinical Advocacy and Support.

Key Responsibilities :

Conduct coverage reviews based on individual member plan benefits and render coverage determinations

Document clinical review findings and engage with requesting providers in peer-to-peer discussions

Communicate and collaborate with network and non-network providers for accurate benefit determinations

Required Qualifications :

M.D or D.O

Active unrestricted license to practice medicine

Board certification approved by the American Board of Medical Specialties (ABMS)

5+ years of clinical practice experience after completing residency training

Sound understanding of Evidence Based Medicine (EBM)