State Licensed Medical Director

Job Summary

A company is looking for a Medical Director - Medicare Grievances and Appeals Corporate.

Key Responsibilities

• Review health claims and preservice appeals, providing medical interpretation and decisions
• Represent the organization at Administrative Law Judge hearings
• Exercise independent judgment on complex issues with minimal supervision

Required Qualifications

• MD or DO degree
• Current and unrestricted license in at least one jurisdiction
• Board Certified in an approved ABMS Medical Specialty
• 5 years of established clinical experience
• Knowledge of the managed care industry including Medicare and Medicaid