A company is looking for a Medical Director - Medicare (Medical Policy & Operations).
Key Responsibilities
Provide clinical expertise and business direction for medical management programs
Support the appeal process, clinical claim review, pre-certification, and predetermination of covered benefits
Analyze data to identify opportunities for quality improvement in health care services
Required Qualifications
Five or more years of experience in the Health Care Delivery System
Active and current state medical license without encumbrances
M.D. or D.O. with Board Certification in an ABMS recognized specialty
Post-graduate direct patient care experience
Medical Director • Boise, Idaho, United States