Medical Director

Job Description

Job Description

Job Description

The Medical Director is responsible for providing final clinical overview and signed authorization of medical appeal decisions. The physician will direct the oversight of the physician panel, provide input in decision on credentialing and specialty recruiting and work closely with multiple departments who manage appeals operations. Oversight will include but will not be limited to:

• Providing clinical input on decision complaints
• Consulting with individual physicians on decisions and concerns
• Reviewing each decision with care to ensure that the case has been reviewed by the appropriate specialty match
• Providing hands on program guidance and support to directors, including reporting metrics and contract deliverables
• Coordination to maintain compliance with URAC/ISO training requirements
• Providing subject matter expertise and adaptive leadership to ensure the completion of current, and the implementation of new project activities

This position is remote and can be based anywhere in the U.S. - Role is 32 hours per week - Friday - Monday

QUALIFICATIONS

• Must hold a current, active, and unrestricted professional license in the U.S. in a recognized discipline
• Maintain licensure in good standing with no active sanctions or disciplinary restrictions
• Must be a strong problem solver that works collaboratively with peers and other staff
• Ability to work independently with minimal supervision and as part of a team.
• Must be able to meet deadlines in a time sensitive environment including off hours coverage

EDUCATION & EXPERIENCE

• Medical Degree as MD or DO
• Board Certification in an identified specialty
• 5+ years of post licensure clinical experience in direct patient care

The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future.

The salary range and/or hourly rate listed does not include other forms of compensation or benefits.

IPRO is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status or military status, or any other category protected under applicable law.