Healthcare Clinical Evaluator MD

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

Key Responsibilities

Review prior authorizations (PAs) under the EPSDT program to determine medical necessity

Collaborate with medical staff and North Carolina Medicaid on PDN and DME cases

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