Job Summary

A staffing agency is filling a position for a Telecommute Physician Review Medical Director.

Core Responsibilities Include:

• Conducting medical case reviews for medical necessity, appeals and denials
• Determining medical necessity using guidelines and policies
• Maintaining the quality of peer clinical and/or appeal case review decision making

Skills and Requirements Include:

• MD/DO, current and unrestricted TX state medical license
• Board Certified by the ABMS
• Managed care review experience
• Medical chart review experience
• Experience with Milliman Guidelines or InterQual Criteria