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Medical Director - Clinical Advocacy
A company is looking for a Medical Director - Clinical Advocacy and Support with a preference for ENT or Internal Medicine. Key Responsibilities Conduct coverage reviews and render coverage determinations based on member plan benefits Document clinical review findings in accordance with policies and regulatory requirements Engage in peer-to-peer discussions with requesting providers and collaborate with network and non-network providers Required Qualifications M.D. or D.O. degree Active unrestricted license to practice medicine Board certification in an ABMS specialty, preferably in Internal Medicine, ENT, Hematology-Oncology, General Surgery, Rheumatology, or PM&R 3+ years of clinical practice experience post-residency Demonstrated understanding of Evidence Based Medicine (EBM)
A company is looking for a Medical Director - Clinical Advocacy and Support with a preference for ENT or Internal Medicine.
Key Responsibilities
Conduct coverage reviews and render coverage determinations based on member plan benefits
Document clinical review findings in accordance with policies and regulatory requirements
Engage in peer-to-peer discussions with requesting providers and collaborate with network and non-network providers
Required Qualifications
M.D. or D.O. degree
Active unrestricted license to practice medicine
Board certification in an ABMS specialty, preferably in Internal Medicine, ENT, Hematology-Oncology, General Surgery, Rheumatology, or PM&R
3+ years of clinical practice experience post-residency
Demonstrated understanding of Evidence Based Medicine (EBM)
