Medical Director - National Medicare Team

Job Summary

A company is looking for a Medical Director for their National Medicare Team.

Key Responsibilities:

• Review preauthorization requests for services and provide medical interpretation
• Determine if services align with national guidelines, CMS requirements, and company policies
• Conduct utilization management of care received by members in an assigned market

Required Qualifications:

• MD or DO degree
• 5+ years of direct clinical patient care experience post residency or fellowship
• Current and ongoing Board Certification in an approved ABMS Medical Specialty
• Current and unrestricted medical license
• No current sanctions from Federal or State Governmental organizations