North Carolina Licensed Clinical Evaluator

A company is looking for a Healthcare Clinical Evaluator SME, MD Required.

Key Responsibilities

Review prior authorizations (PAs) under the EPSDT program and adjudicate PDN and DME prior approval requests

Collaborate with the Medical Director, Physical Therapy, Nurses, and other staff to complete PA requests

Manage incoming PAs and ensure compliance with service level agreements

Required Qualifications

Education : MD / DO

Experience : 15+ years of related experience

Technical skills : Proficiency in Microsoft products and Adobe PDF