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About the role
If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in an on-demand assessment with pre-determined questions. You should anticipate the assessment to take approximately 10-15 minutes. Your on-demand assessment will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews. Found on 1752vc Careers, the job board for startup and VC roles.
What they're looking for
- MD or DO degree
- A current and unrestricted license in at least one jurisdiction, able and willing to obtain a license without conditions , as required, for various states in region of assignment
- No current sanction from Federal or State Governmental organizations, and able to pass credentialing requirements
- Board Certified in an approved ABMS Medical Specialty
- Prompt professional communication skills written and verbally
- 5 years of established clinical experience post residency
More about this role
The Corporate Medical Director relies on medical background and reviews of medical records for appeals decisions. The Corporate Medical Director works on problems of diverse scope and complexity ranging from moderate to substantial.
The Corporate Medical Director provides clinical interpretation and makes determinations regarding the appropriateness of services delivered by other healthcare professionals, in accordance with established review policies, procedures, and performance standards. The Corporate Medical Director exercises independent judgment in addressing complex issues related to job responsibilities and associated tasks, applying critical analysis to variable factors and determining the most appropriate course of action.
- Provide medical interpretation and clinical judgment regarding the appropriateness, necessity, and quality of services rendered by other healthcare professionals.
- Perform or oversee clinical reviews of grievance and appeal cases for assigned markets, member populations, or condition-specific areas.
- Ensure all determinations are made in compliance with medical review policies, regulatory requirements, internal procedures, and performance...
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