Massachusetts Licensed Medical Director

Job Summary

A company is looking for a Medical Director - PRN.

Key Responsibilities

• Perform daily review of home and community-based services to approve or deny services for members
• Represent the health plan in Board of Hearing cases and ensure appropriate utilization management
• Collaborate with clinical staff to support clinical quality initiatives and achieve operational goals

Required Qualifications

• Active/unrestricted Licensed physician in Massachusetts
• Board Certified in an ABMS or AOBMS specialty
• 5+ years clinical practice experience with knowledge of managed care and Medicaid
• 2 - 3 years of quality management experience
• Familiarity with current medical issues and practices