State Licensed Medical Director

A company is looking for a Medical Director - Clinical Advocacy and Support.

Key Responsibilities

Conduct coverage reviews based on individual member plan benefits and render coverage determinations

Document clinical review findings and engage with requesting providers in peer-to-peer discussions

Communicate and collaborate with network and non-network providers for accurate benefit determinations

Required Qualifications

M.D. or D.O. with an active unrestricted license to practice medicine

Board certification in an ABMS specialty preferred (e.g., Internal Medicine, Family Medicine)

3+ years of clinical practice experience post-residency training

Demonstrated understanding of Evidence Based Medicine (EBM)

Proficient in MS Word, Outlook, and Excel