State Licensed Medical Director

Job Summary

A company is looking for a Medical Director - Medical Policy & Operations.

Key Responsibilities

• Provide clinical expertise and business direction for medical management programs
• Support clinical claim review processes, pre-certification, and appeals
• Analyze data to identify quality improvement opportunities in healthcare services

Required Qualifications

• Five or more years of experience in the Health Care Delivery System
• Active and current state medical license without encumbrances
• M.D. or D.O. with Board Certification in an ABMS recognized specialty
• Post-graduate direct patient care experience