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The Medical Management Team provides guidance and oversight of clinical services requested including authorization of services, operations, and overall clinical direction. The team is responsible for maintaining the integrity of the program, including initial and concurrent utilization reviews of services and procedures.
The Physical Health Medical Director assists with oversight of the clinical organization and application of service definition criteria and other standards of care for utilization management requests for services, procedures, and level of care.
This position will offer the ability to work primarily remote. The hire may be required to report on-site as needed. Candidates who are resident of North Carolina or willing to relocate are strongly preferred. The individual in this position may be expected to work weekends as the need arise.
Responsibilities & Duties
Assist with the Development of Service Criteria and Other Standards of Care
Review Approval and Denial of Service Requests
Provide Consultation and Training
Develop Peers and Maintain a Positive Environment
Minimum Requirements
Education & Experience
Required:
Graduation from an accredited Medical School. M.D./D.O. degree is required. Completion of approved residency training in internal medicine or family medicine. At least four (4) years of postgraduate clinical experience.
Special Requirement:
Current, active, and unrestricted license to practice medicine in North Carolina or meets qualifications to obtain a North Carolina Medical License with Board certification for appropriate field of Medicine (American Board of Family Medicine or American Board of Internal Medicine).
Preferred:
Two (2) or more years of managed care and utilization management experience.
Knowledge, Skills, & Abilities
Salary Range
$192,208.00 to $320,346.00/Annually
Exact compensation will be determined based on the candidate’s education, experience, external market data and consideration of internal equity.
An excellent fringe benefit package accompanies the salary, which includes:
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