Louisiana Licensed Medical Director

Job Summary

A company is looking for a Medical Director-Medicaid.

Key Responsibilities

• Oversee Utilization Management, including prior authorization, precertification, and concurrent review
• Ensure timely responses to members and providers regarding precertification and appeal requests
• Participate in a rotating on-call schedule for weekend and holiday coverage

Required Qualifications

• Five or more years of experience in Health Care Delivery System
• Active Louisiana state medical license with the ability to obtain licenses in Florida, Kentucky, and West Virginia
• M.D. or D.O. with current Board Certification in an ABMS or AOA recognized specialty
• Preferred specialties include Family Medicine, Emergency Medicine, or Internal Medicine-Pediatrics
• Prior experience in Utilization Management at a Health Plan or as a Physician Advisor is a plus