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 oversight and clinical decision-making for the utilization management program
• Render denial determinations for services not considered medically necessary

Required Qualifications

• Available to work Thursday through Sunday 8-5 CST
• Doctor of Medicine (MD or DO), licensed in Wisconsin without restriction
• Multi-line business expertise, including ACA, Commercial, and Medicare Advantage
• Utilization Management oversight experience
• Appeals review and adverse determinations experience