Medical Director – Neurologist

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

📋 Description

• Conducts medical necessity reviews focused on benefits for coverage, case management, and claims resolution, utilizing benefit plan details, relevant federal and state regulations, clinical guidelines, and best practice methods.

• Strives to achieve quality results for customers/members with an emphasis on service and cost efficiency.

• Enhances clinical outcomes through daily engagement with healthcare professionals employing active listening, education, and superior communication and negotiation skills.

• Balances the needs of customers/members with business objectives while consistently acting as an advocate for them.

• Involves in all stages of the Appeal process as permitted by relevant regulatory bodies and accreditation organizations.

⛳️ Requirements

• Valid unrestricted medical license in a US state or territory.

• Current board certification (either lifetime certification or one maintained through MOC or another relevant program) in a specialty recognized by ABMS or AOA.

• At least 5 years of clinical practice experience and/or direct patient care beyond residency.

• Computer Proficiency: Extensive use of word processing, spreadsheet, email, PowerPoint, and personal information management programs is required; proficiency in all must be demonstrated or quickly acquired.

• Must not be excluded from participation in any federal healthcare program.

• Must not be listed on CMS’ Preclusion List.

• Preferred Qualifications: Experience in medical management, utilization review, and case management within a managed care environment.

🏝️ Benefits

• From the first day of your employment, you will have access to various health-related benefits, including medical, vision, dental, and well-being and behavioral health programs.

• 401(k) plan.

• Company-funded life insurance.

• Tuition reimbursement program.

• A minimum of 18 days of paid time off each year.

• Paid holidays.

• Eligibility for an annual bonus and long-term incentive plan.