Tennessee Licensed Medical Director

Job Summary

A company is looking for a Medical Director Utilization Management.

Key Responsibilities:

• Conduct coverage reviews and render coverage determinations based on member plan benefits
• Document clinical review findings in accordance with policies and regulatory requirements
• Engage in peer-to-peer discussions with requesting providers and collaborate with network and non-network providers

Required Qualifications:

• M.D. or D.O. degree
• Board certification in Internal Medicine, Family Medicine, or Emergency Medicine
• Active unrestricted medical license in Tennessee
• 5+ years of clinical practice experience post-residency
• Sound understanding of Evidence Based Medicine (EBM)