State Licensed Medical Director

Job Summary

To support clinical operations, the remote State Licensed Medical Director in Women's Health will manage coverage reviews, collaborate with healthcare providers, and ensure quality medical care for members while working full-time.

Key responsibilities:

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

Required qualifications:

• M.D. or D.O. with current board certification through ABMS or AOA
• Board-certified in Obstetrics & Gynecology, Family Medicine, or a relevant specialty with significant Women's Health experience
• Active unrestricted license to practice medicine
• 5+ years of clinical practice experience post-residency
• Proven understanding of Evidence Based Medicine (EBM)