West Virginia Licensed Medical Director

Job Summary

A company is looking for a Medical Director for West Virginia Medicaid.

Key Responsibilities

• Oversee Utilization Management, including prior authorization and concurrent review
• Ensure timely responses to members and providers regarding precertification and appeals
• Support the centralized Medical Management team while working primarily from home

Required Qualifications

• Five or more years of experience in Health Care Delivery System
• Active West Virginia state medical license and ability to obtain licenses in Florida, Louisiana, and Kentucky
• M.D. or D.O. with current and active Board Certification in an ABMS or AOA recognized specialty
• Preferred specialties include Family Medicine, Emergency Medicine, or Internal Medicine-Pediatrics
• Prior experience in Utilization Management or as a Physician Advisor is a plus