Urology Medical Director

Job Summary

A company is looking for a Medical Claims Review Medical Director specializing in Urology, working remotely.

Key Responsibilities

• Conduct coverage reviews and render determinations based on member plan benefits and coverage policies
• Document clinical review findings and engage in peer-to-peer discussions with providers as needed
• Collaborate with network and non-network providers to ensure accurate and timely benefit determinations

Required Qualifications

• M.D. or D.O. with an active unrestricted medical license
• Board certification in Urology
• 5+ years of clinical practice experience post-residency
• Proven understanding of Evidence Based Medicine (EBM)
• Demonstrated proficiency in using MS Word, Outlook, and Excel