State Licensed Appeals Medical DirectorVirtualVocations • Dorchester, Massachusetts, United States
State Licensed Appeals Medical Director
VirtualVocations • Dorchester, Massachusetts, United States
[job_card.variable_days_ago]
[job_preview.job_type]
- [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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