Radiation Oncology Medical Director

Job Summary

Serving as a key member of the utilization management team, the full-time Radiation Oncology Medical Director will review imaging cases, discuss determinations with requesting physicians, and ensure compliance with medical necessity guidelines while working remotely.

Key responsibilities

• Review and assess Radiation Oncology and imaging cases that do not meet medical necessity guidelines
• Engage in peer-to-peer discussions with physicians regarding clinical determinations and provide rationale for appeals
• Ensure accurate documentation of communications and assist with training for Initial Clinical Reviewers

Required qualifications

• MD/DO/MBBS with active Board Certification in Radiation Oncology
• Minimum of five years' experience in medicine, with active clinical practice within the last two years preferred
• Current, unrestricted clinical license in medicine or required specialty
• Proficiency in computer systems and medical review guidelines
• No history of major disciplinary actions or sanctions by any state medical board