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Medica

To better your life with care in the moments that matter.

Medical Director – Clinical Ops Case Review

Medical DirectorMedical DirectorFull TimeRemoteLeadTeam 1,001-5,000Since 1975H1B SponsorCompany SiteLinkedIn

Location

Alabama + 17 moreAll locations: Alabama | Arizona | Florida | Illinois | Iowa | Kansas | Kentucky | Nebraska | North Dakota | Oklahoma | Michigan | Minnesota | Missouri | South Dakota | Tennessee | Texas | Virginia | Wisconsin

Posted

3 days ago

Salary

$235.6K - $319.8K / year

Seniority

Lead

Postgraduate Degree10 yrs expEnglish

Job Description

Medical Director – Clinical Ops Case Review

Medica

• support care management, quality, utilization management, credentialing, pharmacy, health policy implementation, technology assessment and risk management activities • Completes care management case review for cases involving medical necessity review • Completes appeal case review for cases involving medical necessity review • Partners to establish priorities as appropriate for improving service at the point of care • Completes quality of care complaint reviews for cases involving clinical aspects or clinical/service aspects • Participates in rotation to above Committee Participation

Job Requirements

  • Medical Doctorate (MD) or Doctor of Osteopathic Medicine (DO)
  • 10+ years of experience beyond degree
  • 5+ years of leadership experience
  • Must be a licensed physician with current Board certification of ABMS recognized specialty
  • Current medical license to practice must be without restrictions
  • Must be willing and able to successfully apply for medical license in other states as needed

Benefits

  • competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees

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