Claims Management Medical Director

Job Summary

A company is looking for a Claims Management Medical Director.

Key Responsibilities:

• Review and make determinations on requested services, level of care, and site of service at the Appeals/Disputes level
• Review clinical records and prioritize daily work
• Communicate decisions to internal associates and potentially participate in care management

Required Qualifications:

• MD or DO degree
• 5+ years of direct clinical patient care experience
• Board Certified in an approved ABMS Medical Specialty
• Current and unrestricted medical license
• No current sanction from Federal or State Governmental organizations