Remote Appeals M.D. Cardiologist

Job Summary

To support the clinical review process, the remote Appeals M.D. Cardiologist will perform case reviews for appeals and grievances related to various health plans while enjoying a flexible work environment.

Key responsibilities

• Conduct individual case reviews for appeals and grievances concerning medical services and benefit coverage
• Engage with medical directors to discuss appeals decision rationales and benefit interpretations
• Participate in team meetings focused on communication, process improvement, and clinical input for organizational projects

Required qualifications

• MD or DO with an active, unrestricted license
• Board Certified in an ABMS or AOBMS specialty (excluding Pediatrics)
• 5+ years of clinical practice experience