A company is looking for a Clinical Advocacy and Support Medical Director, Internist, Surgery or Plastic Surgery Preferred - Remote.
Key Responsibilities
Conduct coverage reviews based on individual member plan benefits and render coverage determinations
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. with an active unrestricted license to practice medicine
Board certification approved by the American Board of Medical Specialties (ABMS)
5+ years of clinical practice experience after completing residency training
Sound understanding of Evidence Based Medicine (EBM)
Proven solid PC skills, specifically using MS Word, Outlook, and Excel
Medical Director • Clearwater, Florida, United States