Appeals Medical Director - California

Location: Remote

Compensation: Salary

Staff Reviewed: Fri, Apr 05, 2024

This job expires in: 1 days

Job Category: Healthcare

Weekly Hours: Full Time

Career Level: Experienced, Senior Level

Job Summary

A company is looking for an Appeals and Grievances Medical Director with a Radiology specialty.

Key Responsibilities:

Perform individual case review for appeals and grievances for various health plan and insurance products
Communicate with medical directors regarding appeals decision rationales and benefit interpretations
Provide clinical and strategic input in organizational committees and projects

Required Qualifications:

MD or DO with an active, unrestricted license
Board Certified in an ABMS or AOBMS specialty
5+ years of clinical practice experience
2+ years of Quality Management experience
Familiarity with current medical issues and practices

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