State Licensed Dermatology Medical Director

Job Summary

To oversee clinical review and adjudication of appeals and grievances, the remote State Licensed Dermatology Medical Director will manage individual case reviews for various health plan products, collaborate with medical directors on decision rationales, and participate in organizational committees and projects.

Key responsibilities:

• Perform individual case reviews for appeals and grievances related to medical services and clinical criteria
• Communicate with medical directors and network management staff regarding access, availability, and quality issues
• Actively participate in team meetings focused on communication, feedback, and process improvement

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
• Familiarity with current medical issues and practices