Washington Licensed Medical Director

Job Summary

A company is looking for an Internist, ABIM/AOBIM Medical Director to conduct outpatient prior authorizations and ensure compliance with clinical guidelines.

Key Responsibilities:

• Conduct regular reviews of care provided to beneficiaries and recommend necessary adjustments to align with CMS guidelines
• Assist in training clinical teams on CMS guidelines and compliance
• Provide recommendations for improving clinical practices based on data analysis and best practices

Required Qualifications:

• Board-certified clinician (Doctor of Medicine or Doctor of Osteopathy) with at least 3 years of certification
• Active, valid, and unrestricted medical license in at least one U.S. state
• Familiarity with outpatient internal medicine and related specialties
• Utilization management experience preferred
• Willingness to obtain a Washington state medical license preferred