Washington Licensed Medical Director

Job Summary

A company is looking for a Remote Physician (MD/DO) specializing in PMR, Orthopedics, or Neurology for outpatient prior authorizations.

Key Responsibilities:

• Conduct regular case reviews to ensure compliance with CMS guidelines and recommend necessary interventions
• Assist in training clinical teams on CMS guidelines and compliance
• Provide clinical guidance and recommendations for improvements based on data analysis and best practices

Required Qualifications:

• Board-certified clinician (MD/DO) with at least 3 years of experience
• Active, valid, and unrestricted medical license in at least one U.S. state; WA state license preferred
• Specialty designation aligned with PMR, neurology, pulmonology, urology, or orthopedics
• Utilization management experience preferred
• Must not be excluded from Medicare, Medicaid, or CHIP participation