Radiation Oncology Field Medical Director

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

📋 Description

• Act as the Physician match reviewer for Radiation Oncology and imaging cases that do not initially align with applicable medical necessity guidelines.

• Conduct specialty reviews for imaging requests when required by providers, clients, or state regulations necessitating expert review.

• Engage in discussions regarding determinations with requesting physicians or ordering providers within established regulatory timeframes.

• Offer clinical rationale for both standard and expedited appeals.

• Apply medical/clinical review guidelines and parameters to ensure consistency, appropriate utilization, and adherence to policies and URAC/NCQA guidelines.

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

• Guarantee timely and precise documentation of communications with medical office staff and/or MD providers.

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

• Take part in ongoing training under the inter-rater reliability process.

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

⛳️ Requirements

• MD/DO/MBBS degree.

• A minimum of five (5) years of experience in the practice of Medicine, post-residency.

• Preferred active clinical practice within the last 2 years.

• Current, unrestricted clinical license in medicine or the required specialty.

• Must obtain and maintain medical licenses in the state of residence and any licenses mandated by business needs.

• Active Board Certification in Radiation Oncology.

• Strong skills in clinical practice, management, communication, and organization.

• Proficiency in computer usage.

• Energetic and inquisitive with a strong passion for quality and value in healthcare.

• Not currently excluded or sanctioned by any state or federal healthcare program, including Medicare or Medicaid.

• Not identified as an excluded individual by the Office of Inspector General of HHS or GSA.

• No history of significant disciplinary or legal action by a state medical board.

• Comprehensive background check, in-person I-9 verification, and potential drug screening prior to employment.

• Submission of government-issued photo ID and identity verification during interviews.

• High-speed internet connection exceeding 10 Mbps at home.

• Ability to connect directly to the home internet router for applicable call-center duties.

• Use of artificial intelligence tools is prohibited during interviews.

🏝️ Benefits

• Work/life balance.

• Flexibility to adapt work to employees’ lifestyles.

• Autonomy to accomplish tasks.

• Health insurance benefits for eligible employees.

• Comprehensive benefits for qualifying employees.