A company is looking for a Medical Director - Medicaid to review medical authorizations and claims for medical necessity.
Key ResponsibilitiesReview medical authorizations and claims to determine medical necessityConduct discussions with external physicians to gather clinical informationOversee coding practices and clinical documentation, grievances, and appeals processesRequired Qualifications, Training, and EducationDoctor of Medicine or Doctor of OsteopathyBoard-certified in an ABMS- or AOA-recognized specialtyAt least five years of post-training clinical experienceExperience in utilization management review and case management in a health plan settingActive, unencumbered physician license in at least one state in the Humana Medicaid national market
Medical Director - Medicaid
A company is looking for a Medical Director - Medicaid to review medical authorizations and claims for medical necessity. ...
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