Medical Director - California Licensed

A company is looking for a Medical Director - Clinical Advocacy and Support.

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 internal partners

Required Qualifications

M.D. or D.O. degree

Active unrestricted license to practice medicine

Board certification in an ABMS specialty preferred

3+ years of clinical practice experience post-residency

Demonstrated understanding of Evidence Based Medicine (EBM)