Surgeon Medical Director

Job Summary

To support clinical operations, the remote Surgeon Medical Director will conduct medical claims reviews, collaborate with providers on benefit determinations, and ensure quality medical care while working in a flexible environment.

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 an active unrestricted medical license
• Board certification as a Surgeon
• 5+ years of clinical practice experience post-residency
• Sound understanding of Evidence Based Medicine (EBM)
• Proficient in MS Word, Outlook, and Excel