Hawaii Licensed Medical Director

Job Summary

A company is looking for a Medical Director - Clinical Advocacy and Support.

Key Responsibilities

• Conduct coverage reviews based on individual member plan benefits and render coverage determinations
• Document clinical review findings and engage with requesting providers in peer-to-peer discussions
• Communicate and collaborate with network and non-network providers for accurate benefit determinations

Required Qualifications

• M.D. or D.O
• Active unrestricted license to practice medicine
• Board certification approved by the American Board of Medical Specialties (ABMS)
• 5+ years of clinical practice experience after completing residency training
• Sound understanding of Evidence Based Medicine (EBM)