Field Medical Director, Vascular Surgery

This is a fully remote position, open to applicants in United States.

📋 Description

• Act as the specialty match reviewer for Vascular cases that do not initially satisfy the relevant medical necessity criteria.

• Evaluate other imaging requests when providers, clients, or state regulations necessitate specialty reviews by the expert in the field.

• Communicate determinations through peer-to-peer phone discussions with requesting physicians or ordering providers within mandated timeframes.

• Offer clinical justification for both standard and expedited appeals.

• Apply medical/clinical review guidelines and criteria to ensure consistency, appropriate utilization, and adherence to SBU policies/procedures, as well as URAC and NCQA standards.

• Support and serve as a resource for Initial Clinical Reviewers.

• Guarantee timely and precise documentation of interactions with medical office personnel and/or physician providers.

• Engage in ongoing training through the inter-rater reliability process.

• Assist the Senior Medical Director with research pertaining to utilization management processes, interpretation, guidelines, and/or system support.

• Operate as Medical Director for designated health plans or regions upon request, taking responsibility for utilization management alongside the Senior Medical Director.

• Regularly collaborate with leadership, management personnel, other physicians, and staff when physician input is necessary.

⛳️ Requirements

• MD/DO/MBBS is mandatory.

• A current, unrestricted clinical license in medicine or the relevant specialty is required.

• It is necessary to obtain and maintain medical licenses in the state of residence.

• Active Board Certification in Vascular Surgery, or an Active Board Certification in General Surgery with significant experience in Vascular Surgery, is required.

• Strong clinical, management, communication, and organizational skills are essential.

• Must be energetic and inquisitive, with a commitment to quality and value in healthcare.

• Computer proficiency is required.

• A minimum of five (5) years of experience in Vascular Surgery practice is preferred.

• High-speed internet connection of over 10 Mbps is required at home.

• Call center employees must be able to connect directly to the home internet router.

• Submission of a government-issued photo ID and identity verification is necessary.

• A comprehensive background check is mandatory.

• In-person I-9 verification is required.

• Candidates may be subject to drug screening prior to employment.

• Use of AI tools is prohibited during interviews.

• Any misrepresentation will lead to immediate disqualification.

🏝️ Benefits

• Work/life balance.

• Flexible work arrangements.

• Autonomy.

• Comprehensive benefits, including health insurance for eligible employees.