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
Clinical Evaluator • Jamaica, New York, United States