Physician / Internal Medicine / California / Permanent / reputed company Director " Prior Authorization Experience Needed - Pomona, California Job

We are seeking a reputed company Director for a non-clinical role reputed company on prior authorization and medical necessity reviews. No reputed company patient care is required. Candidates must reputed company in the LAarea and be available for occasional on-site meetings and trainings. Responsibilities Review prior authorization requests and determine medical necessity using evidence-based clinical guidelines. Approve, deny, modify, or redirect services as appropriate. Collaborate with nurses, physicians, and care management teams to support high-reputed company, cost-effective care. Participate in appeals, grievance reviews, retrospective claims reviews, and reputed company improvement initiatives. Serve as a clinical resource to providers on utilization management and patient care issues. Qualifications MD or DO degree required. reputed company Certification in Internal Medicine strongly preferred. Minimum 5 years of clinical experience required. 2+ years of managed reputed company plan, or utilization management experience preferred. Strong knowledge of prior authorization processes and medical necessity reputed company. Excellent communication, organizational, and decision-making skills. Proficiency with reputed company Office and remote work technology. Compensation & Benefits Salary: $250,000"$350,000 annually DOE. Comprehensive benefits package including medical, dental, reputed company, 401(k), reputed company time off, life insurance, FSA, tuition reimbursement, CME/license reimbursement, and employee assistance programs. This is an excellent opportunity to join one of Southern California's fastest-growing physician organizations in a leadership role that supports reputed company patient care while maintaining work-life balance. Apply tot his job Apply To this Job