Medical Director DME - Arizona Licensed

Job Summary

To support clinical operations, the remote Medical Director DME - Arizona Licensed will conduct coverage reviews, document clinical findings, and engage with providers to ensure effective benefit determinations for members.

Key responsibilities

• Conduct coverage reviews based on individual member plan benefits and render coverage determinations
• Document clinical review findings in accordance with policies and regulatory requirements
• Communicate with network and non-network providers to facilitate accurate and timely benefit determinations

Required qualifications

• M.D or D.O
• Active unrestricted license to practice medicine
• Board certification in Physical Medicine & Rehabilitation, Internal Medicine, Emergency, or Family Medicine
• 3+ years of clinical practice experience post-residency
• Sound understanding of Evidence Based Medicine (EBM)