Job Summary
A company is looking for a Medical Director, Grievances.
Key Responsibilities
- Provide leadership direction for provider credentialing processes
- Ensure timely medical decisions and participate in quality improvement and care management goals
- Communicate clinical guidelines and represent the Health Plan in external accreditation activities
Required Qualifications
- Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) from an accredited school
- Active Pennsylvania Medical License
- Board certification in a relevant medical specialty
- Experience in quality improvement and utilization management
- Ability to work remotely for 10-18 hours per week
Comments