Medical Director - DME - TX Licensed

Job Summary

A company is looking for a Medical Director - Prior Authorization - DME - Remote.

Key Responsibilities

• Conduct coverage reviews for DME requests and therapy services based on member plan benefits
• Document clinical review findings and engage in peer-to-peer discussions with providers as needed
• Communicate and 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 certification in Physical Medicine & Rehabilitation, Internal Medicine, or Family Medicine
• 5+ years of clinical practice experience post-residency
• Sound understanding of Evidence Based Medicine (EBM)
• Proficient in MS Word, Outlook, and Excel