Washington Licensed Assistant Medical Director

Job Summary

A company is looking for an Assistant Medical Director with a Behavioral Health focus for a part-time position.

Key Responsibilities

• Perform clinical reviews of behavioral health services and make coverage decisions based on medical necessity
• Support peer-to-peer discussions with external physicians regarding denial determinations and gather additional clinical history
• Participate in the development and approval of medical review criteria and conduct secondary reviews for member and provider appeals

Required Qualifications, Training, and Education

• Licensed Physician with an MD or DO degree
• Unrestricted Washington MD or Alaska DO state licensure, or ability to obtain within 90 days
• Current board certification in psychiatry from the American Board of Psychiatry and Neurology
• Five years of clinical experience in psychiatry
• Previous experience with medical necessity and clinical reviews in a health plan setting is preferred