State Licensed Medical Director

Job Summary

A company is looking for a UM Clinical Review - Anesthesiology or PM&R with Pain Management.

Key Responsibilities:

• Conduct coverage reviews based on individual member plan benefits and national coverage review policies
• Document clinical review findings and engage with requesting providers in peer-to-peer discussions
• Communicate and collaborate with network and non-network providers for accurate benefit determinations

Required Qualifications:

• M.D. or D.O. with an active unrestricted license to practice medicine
• Board certification in PM&R or Anesthesiology with experience in pain management
• 5+ years of clinical practice experience after residency training
• Sound understanding of Evidence Based Medicine (EBM)
• Participation in rotational call coverage