Medical Director - Family Medicine

A company is looking for a UM Medical Director specializing in Family Medicine, Internal Medicine, or Sports Medicine, to work remotely.

Key Responsibilities :

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

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

Communicate and collaborate with network and non-network providers to ensure accurate benefit determinations

Required Qualifications :

M.D. or D.O. with an active unrestricted license to practice medicine

Board certified in Family Medicine, Internal Medicine, or Sports Medicine

5+ years of clinical practice experience post-residency

Proven understanding of Evidence Based Medicine (EBM)

Ability to participate in rotational holiday and call coverage