Texas Licensed Medical Director

Job Summary

A company is looking for a Medical Director Utilization Management - Remote.

Key Responsibilities:

• Conduct coverage reviews and render determinations based on member plan benefits and policies
• Document clinical review findings and engage in peer-to-peer discussions with providers
• Communicate and collaborate with providers and internal partners for accurate benefit determinations

Required Qualifications:

• M.D. or D.O
• Board certification in Internal Medicine, Family Medicine, or Emergency Medicine
• 5+ years of clinical practice experience post-residency
• Proven understanding of Evidence Based Medicine (EBM)
• Ability to participate in rotational holiday and call coverage