Massachusetts Licensed Medical DirectorVirtualVocations • Lincoln, Nebraska, United States
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Massachusetts Licensed Medical Director
VirtualVocations • Lincoln, Nebraska, United States
[job_card.30_days_ago]
[job_preview.job_type]
- [job_card.full_time]
[job_card.job_description]
A company is looking for a Medical Director, Clinical Reviews.
Key Responsibilities
Perform clinical reviews for utilization management, including prospective, concurrent, and retrospective coverage requests
Communicate with providers and facilities to resolve clinical issues and support the provider inquiry process
Conduct quality of care reviews and assist with credentialing reviews for providers and facilities
Required Qualifications
Current unrestricted license as a medical or osteopathic doctor
Board-Certified MD or DO in a specialty recognized by the American Board of Medical Specialties
Minimum of five years of clinical experience
Experience in utilization management or quality management preferred
Ability to perform utilization management activities in accordance with accreditation standards
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Medical Director • Lincoln, Nebraska, United States
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