Medical Director - Arizona Licensed

A company is looking for a Clinical Review Medical Director - Internist, Surgery or Plastic Surgery - Remote.

Key Responsibilities

Conduct coverage reviews based on individual member plan benefits and national coverage review policies

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 in Internal Medicine, Surgery or Plastic Surgery

5+ years of clinical practice experience after completing residency training

Sound understanding of Evidence Based Medicine (EBM)