State Licensed Medical Director

Job Summary

A company is looking for a Medical Director - Medicare Appeals.

Key Responsibilities

• Provide oversight for medical policy implementation
• Review appeal cases for denied medical services, including various levels of appeals and hearings
• Act as a liaison to network providers and facilities to support medical services programs

Required Qualifications

• Two (2) or more years of experience in Health Care Delivery System
• Prior Utilization Management experience
• Active and current state medical license without encumbrances
• M.D. or D.O., Board Certification in an ABMS or AOA recognized specialty
• Post-graduate direct patient care experience