Surgeon Medical Director

Job Summary

Providing clinical oversight and support, the remote Surgeon Medical Director will conduct coverage reviews, document findings, and engage in peer-to-peer discussions, ensuring effective management of medical benefits while working full-time in a collaborative environment.

Key responsibilities

• Conduct coverage reviews based on individual member plan benefits and render coverage determinations
• Document clinical review findings and actions in accordance with policies and regulatory requirements
• Communicate and collaborate with network and non-network providers to ensure accurate benefit determinations

Required qualifications

• M.D. or D.O. with an active unrestricted medical license
• Current board certification as a Surgeon through ABMS or AOA
• 5+ years of clinical practice experience post-residency
• Proven understanding of Evidence Based Medicine (EBM)
• Demonstrated proficiency in MS Word, Outlook, and Excel