Otolaryngology Medical Director

Job Summary

To support clinical operations, the remote Otolaryngology Medical Director will manage coverage reviews, collaborate with healthcare providers, and ensure quality medical care for members while adhering to PST hours.

Key responsibilities:

• Conduct coverage reviews based on individual member plan benefits and render coverage determinations
• Document clinical review findings and engage in peer-to-peer discussions with requesting providers
• Communicate and collaborate with network and non-network providers to ensure accurate benefit determinations

Required qualifications:

• M.D. or D.O
• Board certification in Otolaryngology (ENT)
• Active unrestricted license to practice medicine
• 5+ years of clinical practice experience after completing residency training
• Demonstrated understanding of Evidence Based Medicine (EBM)