Arizona Licensed Medical Director

Job Summary

A company is looking for a Medical Director (Medicare).

Key Responsibilities

• Determines appropriateness and medical necessity of healthcare services for plan members
• Supports and evaluates the plan's utilization management program to ensure high-quality member care
• Educates network providers on utilization practices and participates in the appeals process for quality of care concerns

Required Qualifications

• At least 3 years of healthcare experience, including 2 years of medical practice experience
• Active and unrestricted MD or DO license in the state of practice
• Board certification
• Working knowledge of relevant laws and regulatory requirements
• Ability to work collaboratively within a matrixed organization