MA Licensed Medical Director

Job Summary

A company is looking for a UM Medical Director - Internal Medicine - Remote.

Key Responsibilities

• Conduct coverage reviews based on member plan benefits and coverage review policies
• Document clinical review findings and engage with providers in peer-to-peer discussions
• Collaborate with network and non-network providers to ensure accurate benefit determinations

Required Qualifications

• M.D. or D.O. with an active unrestricted license to practice medicine
• Board certified in Internal Medicine
• 5+ years of clinical practice experience after residency training
• Proven understanding of Evidence Based Medicine (EBM)
• Ability to participate in rotational holiday and call coverage