Genetics Medical Director

Job Summary

A company is looking for a Utilization Management Medical Director, Genetics - Remote.

Key Responsibilities

• Conduct coverage reviews and render coverage determinations based on member plan benefits
• Document clinical review findings and engage with providers in peer-to-peer discussions
• Communicate with network and non-network providers regarding benefit determinations and educate them on medical policy

Required Qualifications

• M.D. or D.O. with an active unrestricted license to practice medicine
• Board certification in Internal Medicine or Family Medicine, including genetics experience
• Ability to obtain additional licenses as needed
• Sound understanding of Evidence Based Medicine (EBM)
• Solid PC skills, specifically using MS Word, Outlook, and Excel