Family Medicine Medical Director

Job Summary

Working remotely from anywhere in the U.S., the full-time salaried Family Medicine Medical Director will provide clinical support for Enterprise Clinical Services operations, focusing on coverage determinations, quality improvement, and cost-effective care management for members.

Key responsibilities

• Conduct coverage reviews and render determinations based on individual member plan benefits and coverage review policies
• Document clinical review findings and engage in peer-to-peer discussions with requesting providers as needed
• Communicate and collaborate with network and non-network providers to ensure timely benefit determinations and educate on medical policies

Required qualifications

• M.D. or D.O
• Board certification in Family Medicine through ABMS or AOA
• Active unrestricted medical license with the ability to obtain additional state licenses
• 5+ years of clinical practice experience post-residency
• Strong understanding of Evidence Based Medicine (EBM)