The Medical Director reviews clinical cases for Medicare and Medicaid members, ensures compliance with review policies and regulatory standards, and identifies opportunities for medical management operational improvements.
Requirements
- MD or DO degree
- Current, active and ongoing board certification from the American Board of Medical Specialties (ABMS) or the American Osteopathic Association Bureau of Osteopathic Specialties (AOABPS)
- Current and unrestricted state license in at least one state and willing to obtain other medical licenses, as required, for various states in region of assignment
- No sanctions from Federal or State Governmental organizations
- 10 years of direct clinical patient care experience post residency or fellowship
- The ability to pass credentialing requirements
- Intermediate to advanced skills utilizing Microsoft Office and Internet navigation
- Strong verbal and written communication skills, with the ability to analyze information and interpret data clearly and accurately
- Adaptable and willing to learn new technologies to enhance workflow efficiency
- Participate in educational activities by attending required conferences and creating content to present for individual subject matter contribution
Benefits
- Medical, dental and vision benefits
- 401(k) retirement savings plan
- Time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
- Short-term and long-term disability
- Life insurance