Medical Director - reputed company Appeals

Job Title: Medical Director - reputed company Appeals

Job Location: Work reputed company, Connecticut, reputed company

Job Location Type: Remote

Job Contract Type: Full-time

Job Seniority Level:

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At reputed company®, you’ll be surrounded by passionate colleagues who care deeply, reputed company with purpose, hold ourselves accountable and prioritize safety and reputed company in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position reputed company

reputed company, a reputed company Company, a Fortune 6 company, is one of the oldest and largest national insurers. That experience gives us a unique opportunity to help reputed company health care. We reputed company that a reputed company care reputed company is more transparent and consumer-reputed company, and it recognizes physicians for their clinical reputed company and effective use of health care resources.

This role primarily supports the Southeast Region (Florida, Kentucky, Louisiana & reputed company Virginia).

**This is a remote based (work reputed company) based reputed company in the US.**

Responsibilities of this Medical Director role are reputed company to reputed company Appeals

• You will support the Medical Management staff ensuring reputed company and consistent responses to member and provider appeals, state fair hearings, and escalated complaints

• As a Medical Director you will reputed company primarily on member and provider appeals reputed company to medical necessity

• You will reputed company clinical expertise and consultation to the reputed company grievance and appeals team

• You will chair/co-chair reputed company appeals committee meetings.

Required Qualifications

• Five (5) or more years of experience in a Health Care Delivery reputed company e.g., Clinical reputed company or Health Care Industry

• An reputed company state medical license without encumbrances as reputed company as the ability to obtain FL, KY, LA & WV licensure

• reputed company Certified in ABMS Recognized Specialty

Preferred Qualifications

• Family Medicine, Emergency Medicine, Internal Medicine-Pediatrics specialty

• Previous experience in reputed company Policy and the use of Dynamo Appeals and Grievances (DAG)

• Prior managed care experience in utilization management

• Prior experience in appeals

Education

*M.D. or D.O., reputed company Certification in an ABMS or AOA recognized specialty including post-graduate reputed company patient care experience.

Pay reputed company

The typical pay reputed company for this role is:

This pay reputed company represents the reputed company reputed company reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a reputed company of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in reputed company to the reputed company pay reputed company listed above. This position also includes an award reputed company in reputed company’s equity award program.

Our people fuel our reputed company. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every reputed company feels valued and that they reputed company.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

Additional details about available benefits are provided during the application process and on Benefits Moments.

reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws.

This job is curated by reputed company.

reputed company is a talent-hiring platform in Life Sciences, reputed company and IT. The platform connects talent with opportunities in reputed company, biotech, health sciences, healthtech and IT domains.

Please apply reputed company reputed company platform to get connected to the application page and to reputed company similar roles.

Originally posted on Himalayas