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California Licensed Cardiology Director
A company is looking for an Appeals and Grievances Medical Director specializing in Cardiology, working remotely. Key Responsibilities Conduct individual case reviews for appeals and grievances related to various health plan products Respond to regulatory inquiries from the Department of Insurance, Department of Managed Healthcare, and CMS Collaborate with medical directors and network management on access, availability, and quality issues Required Qualifications MD or DO with an active, unrestricted license Board Certified Cardiologist in an ABMS or AOBMS specialty 5+ years of clinical practice experience 2+ years of Quality Management experience Intermediate proficiency with managed care
A company is looking for an Appeals and Grievances Medical Director specializing in Cardiology, working remotely.
Key Responsibilities
Conduct individual case reviews for appeals and grievances related to various health plan products
Respond to regulatory inquiries from the Department of Insurance, Department of Managed Healthcare, and CMS
Collaborate with medical directors and network management on access, availability, and quality issues
Required Qualifications
MD or DO with an active, unrestricted license
Board Certified Cardiologist in an ABMS or AOBMS specialty
5+ years of clinical practice experience
2+ years of Quality Management experience
Intermediate proficiency with managed care