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State Licensed Appeals Medical Director
State Licensed Appeals Medical DirectorVirtualVocations • Dorchester, Massachusetts, United States
State Licensed Appeals Medical Director

State Licensed Appeals Medical Director

VirtualVocations • Dorchester, Massachusetts, United States
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  • [job_card.full_time]
[job_card.job_description]

A company is looking for an Appeals M.D. - PM&R required for a remote position.

Key Responsibilities

Conduct individual case reviews for appeals and grievances related to various health plans and insurance products

Respond to regulatory inquiries from the Department of Insurance, Department of Managed Healthcare, and CMS

Collaborate with medical directors and staff regarding appeals decisions, network issues, and participate in organizational committees

Required Qualifications

MD or DO with an active, unrestricted license

Board Certified in an ABMS or AOBMS specialty (excluding Pediatrics)

5+ years of clinical practice experience

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Medical Director • Dorchester, Massachusetts, United States

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