Medical Director - Genetics (MA, MN)

Job Summary

To support clinical operations, the remote Medical Director - Genetics (MA, MN) will manage coverage reviews, document clinical findings, and engage with providers to ensure cost-effective quality medical care for members.

Key responsibilities

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

Required qualifications

• M.D. or D.O. with an active unrestricted license to practice medicine
• Board certified in Medical Genetics and Genomics or Family/Internal Medicine with genetics training
• 5+ years of clinical practice experience post-residency
• Proven understanding of Evidence Based Medicine (EBM)
• PC skills, specifically using MS Word, Outlook, and Excel