Medical Director - Internal Medicine

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

Mar 20, 2025 - 16:37

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