Physician Medical Director

Job Summary

Working remotely, the part-time Physician Medical Director will manage clinical reviews, collaborate with providers on benefit determinations, and ensure quality medical care for members across various lines of business.

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
• Active unrestricted license to practice medicine
• Board certification in Physical Medicine & Rehabilitation, Internal Medicine, or Family Medicine
• 5+ years of clinical practice experience after completing residency training
• Sound understanding of Evidence Based Medicine (EBM)