A company is looking for a Utilization and Clinical Review - Medical Director - Orthopedic Surgery.
Key Responsibilities
Conduct coverage reviews for musculoskeletal surgical procedures and document clinical findings according to regulatory standards
Coordinate with clinical staff and engage in peer-to-peer discussions with requesting providers
Participate in training and ensure compliance with various regulatory requirements
Required Qualifications
MD or DO with an active, unrestricted medical license
Board Certification in Orthopedic Surgery
5+ years of clinical practice experience post-residency
Sound understanding of Evidence Based Medicine (EBM)
Proficient with MS Office applications
Orthopedic Surgery • Fremont, California, United States