Corporate Medical Director

VirtualVocations
Jersey City, New Jersey, United States
Full-time
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A company is looking for a Medicare Grievances and Appeals Corporate Medical Director to oversee health claims and preservice appeals.

Key ResponsibilitiesReview health claims and preservice appeals to provide medical interpretation and decisionsRepresent the organization at Administrative Law Judge hearingsExercise independent judgment on complex issues related to healthcare services complianceRequired QualificationsMD or DO degree with a current and unrestricted license in at least one jurisdictionBoard Certified in an approved ABMS Medical SpecialtyFive years of established clinical experienceKnowledge of the managed care industry, including Medicare and MedicaidWillingness to obtain licenses for various states as required

2 days ago
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