State Licensed Medical Director

A company is looking for a Medical Director - Medicare (Medical Policy & Operations).

Key Responsibilities

Provide clinical expertise and business direction for medical management programs

Support the appeal process, clinical claim review, pre-certification, and predetermination of covered benefits

Analyze data to identify opportunities for quality improvement in health care services

Required Qualifications

Five or more years of experience in the Health Care Delivery System

Active and current state medical license without encumbrances

M.D. or D.O. with Board Certification in an ABMS recognized specialty

Post-graduate direct patient care experience