Medical Director - MN LicensedVirtualVocations • Rockville, Maryland, United States
Medical Director - MN Licensed
VirtualVocations • Rockville, Maryland, United States
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A company is looking for a Medical Director for Medical Claims Review, working remotely.
Key Responsibilities
Conduct coverage reviews based on individual member plan benefits and national policies, rendering coverage determinations
Document clinical review findings and engage in peer-to-peer discussions with requesting providers as needed
Communicate and collaborate with network and non-network providers to ensure accurate and timely benefit determinations
Required Qualifications
M.D. or D.O. with an active unrestricted license to practice medicine
Board certification approved by the AMBS or AOBMS specialty
5+ years of clinical practice experience after completing residency training
Proven understanding of Evidence Based Medicine (EBM)
Demonstrated proficiency in PC skills, specifically using MS Word, Outlook, and Excel
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Medical Director • Rockville, Maryland, United States
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