Radiation Oncologist Medical Director

Job Summary

To support the adjudication of appeals and grievances, the remote Appeals and Grievances Medical Director - Radiation Oncologist will perform clinical reviews, communicate with medical directors, and participate in organizational committees, while enjoying the flexibility of a virtual work environment.

Key responsibilities:

• Perform individual case reviews for appeals and grievances related to various health plan products
• Communicate with medical directors regarding appeals decision rationales and benefit interpretations
• Provide clinical and strategic input in organizational committees and process improvement initiatives

Required qualifications:

• MD or DO with an active, unrestricted license
• Board Certified in an ABMS or AOBMS specialty
• 5+ years of clinical practice experience
• 2+ years of Quality Management experience
• Intermediate or higher proficiency with managed care