Medical Director – Duals Center of Excellence

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

📋 Description

• Conduct concurrent and prior authorization assessments alongside peer-to-peer evaluations of denials.

• Manage appeals within their designated 'base plans' and may distribute tasks based on 'same or similar specialty' requirements.

• Carry out pharmacy evaluations.

• Engage in and have the capability to lead rounds.

⛳️ Requirements

• A minimum of 3-5 years of experience in clinical practice.

• At least two (2) years of experience in managed care (Medicare and/or Medicaid).

• Preferred experience in managed care (Medicare and Medicaid) utilization review.

• MD or DO; board certification in a specialty recognized by ABMS or AOA is mandatory.

• A current and active state medical license without any encumbrances is required.

• Holding multiple state licenses is an advantage.

🏝️ Benefits

• Medical, dental, and vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• CVS Health bonus, commission, or short-term incentive program.