Massachusetts Licensed Medical Director
Location: Remote
Compensation: To Be Discussed
Staff Reviewed: Fri, Jan 10, 2025
This job expires in: 25 days
Job Summary
A company is looking for a Medical Director, Clinical Reviews to perform utilization management and provider payment reviews.
Key Responsibilities
- Conduct clinical reviews of prospective, concurrent, and retrospective coverage requests
- Communicate with providers and facilities to resolve clinical issues and support peer-to-peer discussions
- Perform quality of care reviews and assist with credentialing for providers and facilities
Qualifications
- Current unrestricted license as a medical or osteopathic doctor
- Board-Certified MD or DO in an American Board of Medical Specialty
- Minimum of five years of clinical experience
- Experience in utilization management or quality management preferred
- Understanding of utilization management and quality assurance principles
COMPLETE JOB DESCRIPTION
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