Medical Director - MN Licensed

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