Wisconsin Licensed Medical Director

Job Summary

A company is looking for a Medical Director to support utilization management and appeals oversight for a temporary engagement.

Key Responsibilities

• Assist the Chief Medical Officer with monitoring care rendered by providers
• Participate in clinical decision-making for the utilization management program
• Render denial determinations and manage appeals, ensuring turnaround times are met

Required Qualifications

• Doctor of Medicine (MD or DO) licensed in Wisconsin without restriction
• Experience with ACA, Commercial, and Medicare Advantage lines of business
• Available to work Monday-Friday, 8:00am-5:00pm CT
• Proficiency with QuickBase, Microsoft Teams, and Microsoft Office Suite
• Expertise in utilization management and regulatory compliance