Medical Director Associate

This is a fully remote position, open to applicants in Florida, +3 more states.

📋 Description

• Assist with pharmacy prior authorization evaluations to adhere to turnaround times and fulfill Pharmacy Benefit Management regulatory standards.

• Offer clinical direction for pharmacy prior authorizations utilizing CarelonRx clinical protocols.

• Aid clinicians in delivering prompt and consistent replies to members and providers.

• Perform peer-to-peer prior authorization assessments for medications with attending physicians or other prescribing providers.

• Engage in a physician on-call weekend rotation for a 24/7 unit.

⛳️ Requirements

• MD or DO degree is mandatory.

• Board certification recognized by the American Board of Medical Specialties (ABMS) or American Osteopathic Association (AOA), as applicable to the responsibilities undertaken.

• Possession of an active, unrestricted medical license to practice medicine or a health profession.

• Must reside in a state or territory of the United States while performing utilization reviews or appeals considerations, unless explicitly permitted by law or regulation.

• Cannot be situated on a US military base, vessel, or embassy while conducting utilization reviews or appeals considerations.

• A minimum of 5 years of clinical experience, or an equivalent mix of education and experience.

• Experience in utilization management is preferred.

• Openness to participate in a physician on-call weekend rotation for a 24/7 unit.

🏝️ Benefits

• Merit increases.

• Paid holidays.

• Paid Time Off.

• Incentive bonus programs.

• Medical benefits.

• Dental benefits.

• Vision benefits.

• Short-term disability benefits.

• Long-term disability benefits.

• 401(k) with matching contributions.

• Stock purchase plan.

• Life insurance.

• Wellness programs.

• Financial education resources.

• Virtual full-time work arrangement, except for mandatory in-person training sessions.