Job Summary
A health services company needs applicants for an opening for a Remote Duals Center of Excellence Medical Director.
Individual must be able to fulfill the following responsibilities:
- Perform concurrent and prior authorization reviews
- Perform appeals in their “base plan” and “same or similar specialty” needs
- Conduct pharmacy reviews and ensure timely and consistent responses to members and providers
Applicants must meet the following qualifications:
- MD or DO; Minimum 3-5 years of clinical practice experience
- Two (2) + years of experience in managed care (Medicare and/or Medicaid)
- Experience with managed care (Medicare and Medicaid) utilization review preferred
- Board certification in an ABMS or AOA recognized specialty is required
- Licensed in or willing to obtain license in at least one state where we have an Integrated plan
