Pennsylvania Licensed Medical Director

Job Summary

A company is looking for a Pennsylvania Licensed Medical Director.

Key Responsibilities

• Perform daily medical reviews, appeals, and physician peer review activities
• Identify and implement evidence-based practice guidelines for quality clinical care
• Manage day-to-day operations to optimize the use of behavioral and physical health services

Required Qualifications

• MD with a license to practice in Pennsylvania; additional state licensure required
• Board-certified in Internal Medicine or Family Medicine
• 1 to 3 years of Health Plan experience
• Must be clear of any sanctions by the applicable state or Office of the Inspector General
• Must not be prohibited from participating in any Federally or State funded healthcare programs