Gastroenterology – Medical Director - Remote

Full-Time or Part-Time position, 100% Work at Home

In this role, you will:

• 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 500 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.
• Create new knowledge with our guidelines and systems, and new relationships with your peers. You’ll start with remote training, but you’re not doing it alone. You’ll enjoy a supportive environment with your peers, mentors, and leadership who want you to succeed in your new career.

About the GI program:

• Cutting edge. Continue learning and growing with the latest and greatest literature and guidelines in Gastroenterology.
• Impact patient care nationally. Have one the largest Gastroenterology 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
• Career opportunities and growth. Our Associate Medical Directors have career growth opportunities.

Qualifications:

M.D. or D.O. with a current, active, U.S. state medical license and board certified in Gastroenterology, recognized by the American Board of Medical Specialties (ABMS), or American Osteopathic Association (AOA).

Recent practice experience in direct patient care

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

Benefits:

Competitive compensation and benefits package

Predictable work schedules