Looking for an intellectually stimulating role that will challenge you to use your current knowledge and build new skills? Join us as an Medical Director at to conduct chart reviews, where you’ll be empowered to make a difference in the lives of patients by improving the quality of healthcare nationwide.
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 over a team of 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.
About the Cardiology program:
Cutting edge. Continue learning and growing with the latest and greatest literature and guidelines in Cardiology
Impact patient care nationally. the organization has one the largest Cardiology 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
Ideal candidate is offered
Competitive base salary with benefits
Predictable work schedules
100% Work at Home with part-time & full-time opportunities available
Health coverage effective day 1 (including medical, dental, vision)
8 Paid Holidays plus 23 PTO Days
401K with company match.
M.D. or D.O. with a current, active, U.S. state medical license and board certified in Cardiology, 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 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 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