State Licensed Medical Director

Job Summary

A company is looking for a Medical Director (Medical Policy & Operations).

Key Responsibilities

• Provide clinical expertise and business direction for medical management programs
• Support appeal processes, clinical claim reviews, and pre-certification of benefits
• Collaborate with diverse health delivery professionals to enhance quality and efficiency of care services

Required Qualifications

• Five or more years of experience in the Health Care Delivery System
• Active and current state medical license without encumbrances
• M.D. or D.O. with Board Certification in an ABMS recognized specialty
• Post-graduate direct patient care experience