A company is looking for a Healthcare Clinical Evaluator SME, MD Required.
Key Responsibilities
Review prior authorizations (PAs) under the EPSDT program and adjudicate PDN and DME prior approval requests
Collaborate with the Medical Director, Physical Therapy, Nurses, and other staff to complete PA requests
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 • Saint Louis, Missouri, United States