Medical Director - Clinical Advocacy

Job Summary

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

Key Responsibilities

• Provide physician support for clinical review of service requests and benefit coverage determinations
• Collaborate with multidisciplinary teams to ensure cost-effective quality medical care for members
• Engage in utilization management activities focusing on pre-service benefit and coverage determination

Required Qualifications

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