Job Summary
A healthcare company is searching for a person to fill their position for a Telecommute Arizona Hawaii or Mississippi Licensed Clinical Coverage Review Medical Director.
Core Responsibilities Include:
- Conducting coverage review based on individual member plan documents
- Conducting daily clinical review and evaluation of all service requests
- Providing support for CCR nurses and non clinical staff in multiple sites
Qualifications for this position include:
- Active, unrestricted physician license
- Current board certification in ABMS or AOA specialty
- 5+ years of clinical practice experience after completing residency training
- 5+ years hands-on experience in utilization and coverage review in a health plan with Commercial membership
- Substantial experience in using electronic clinical systems in the payer setting
- Sound knowledge of the managed care industry
