Job Number: 2553
Salary / Pay Rate: $260,000.00
Looking for an intellectually stimulating role that will challenge you to use your current knowledge and build new skills? Join us as a Medical Director, where you’ ll be empowered to make a difference in the lives of patients by improving the quality of healthcare nationwide.
What you’ ll do:
Use your analytical mindset. Provide timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria. Review appeals for denied services related to relevant medical experience and our evidence-based guidelines, in accordance with appeal policies, if so delegated.
Be a team player. Work collaboratively with Physician Peers to help ensure patients receive proper care via evidence-based decision-making. Provide timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions.
Create new knowledge with our guidelines and systems, and new relationships with your peers. You’ ll start with remote training, but you’ re not doing it alone. You’ ll enjoy a supportive environment with your peers, mentors, and leaders who want you to succeed in your new career.
About the GI program:
Cutting edge. Continue learning and growing with the latest and greatest literature and guidelines in Gastroenterology.
Impact patient care nationally. We have one the largest Gastroenterology Prior Authorization program in the country, providing you a chance to impact clinical change on a nationwide scale while supporting patients in all U.S. Time zones
Career opportunities and growth. Our Associate Medical Directors have career growth opportunities.
Why join us?
- Salaried position with benefits
- Predictable work schedules
- 100% Work at Home with full-time and part-time opportunities available
- Health coverage effective day 1 (including medical, dental, and vision)
- 8 Paid Holidays plus 23 PTO Days
- 401K with company match
- CME Reimbursement
What you should have:
- M.D. Or D.O. With a current, active, U.S. State medical license and board certified in Gastroenterology, recognized by the American Board of Medical Specialties (ABMS), or American Osteopathic Association (AOA).
- Recent practice experience in direct patient care (within the past 18 months)
- Must have a minimum of 5 years of clinical experience, beyond residency/fellowship
- Knowledge of applicable state and federal laws. Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance (NCQA)standards are a plus
- The ability to commit to a set, weekly work schedule (Monday through Friday)
- Strong computer skills; ability to work autonomously with automated processes and computer applications and systems is required
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