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West Virginia Licensed Medical Director
A company is looking for a Medical Director for West Virginia Medicaid. Key Responsibilities Oversee Utilization Management, including prior authorization and concurrent review Ensure timely responses to members and providers regarding precertification and appeals Support the centralized Medical Management team while working primarily from home Required Qualifications Five or more years of experience in Health Care Delivery System Active West Virginia state medical license and ability to obtain licenses in Florida, Louisiana, and Kentucky M.D. or D.O. with current and active Board Certification in an ABMS or AOA recognized specialty Preferred specialties include Family Medicine, Emergency Medicine, or Internal Medicine-Pediatrics Prior experience in Utilization Management or as a Physician Advisor is a plus
A company is looking for a Medical Director for West Virginia Medicaid.
Key Responsibilities
Oversee Utilization Management, including prior authorization and concurrent review
Ensure timely responses to members and providers regarding precertification and appeals
Support the centralized Medical Management team while working primarily from home
Required Qualifications
Five or more years of experience in Health Care Delivery System
Active West Virginia state medical license and ability to obtain licenses in Florida, Louisiana, and Kentucky
M.D. or D.O. with current and active Board Certification in an ABMS or AOA recognized specialty
Preferred specialties include Family Medicine, Emergency Medicine, or Internal Medicine-Pediatrics
Prior experience in Utilization Management or as a Physician Advisor is a plus
