Medical Director – Appeals

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

📋 Description

• Manage specific components of medical policies and programs.

• Execute medical reviews.

• Engage with provider communities in designated areas.

• Carry out electronic documentation for case reviews.

⛳️ Requirements

• Must be a Physician (M.D. or D.O.) holding a current and unrestricted medical license in a state or territory of the United States.

• Must maintain Board Certification through a specialty board recognized by the American Board of Medical Specialties, National Board of Physicians and Surgeons, or the Advisory Board of Osteopathic Specialists.

• Minimum of 5 years of clinical experience required.

• Strong analytical and communication abilities.

• Proficient in strategic thinking.

• Adept in computer skills, including Microsoft Office and Lotus Notes, for electronic documentation of case reviews.

• Preferred 3 years of experience in Managed Care.

• Specialties in Cardiology, Gastroenterology, Rheumatology, Dermatology, Hematology, Oncology, or internal medicine are preferred but not mandatory.

🏝️ Benefits

• Tailored development plans promoting growth and rewarding careers.

• Comprehensive health and wellness benefits.

• 401(k) savings plan.

• Pension plan.

• Paid time off.

• Paid parental leave.

• Disability insurance.

• Supplemental life insurance.

• Employee assistance program.

• Paid holidays.

• Tuition reimbursement.

• Various incentives.

• Annual incentive bonus plan subject to plan terms and conditions.