Field Medical Director, MSK Surgery
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Job Description
Field Medical Director for MSK Surgery in non-clinical environment serving as Physician match reviewer. Collaborating with utilization management team to improve health outcomes.
Responsibilities:
- Serve as the Physician match reviewer in Hip/Knee/Shoulder Surgery cases
- Discusses determinations (peer to peer phone calls) with requesting physicians or ordering providers
- Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review process
- Aids and acts as a resource to Initial Clinical Reviewers
- Ensures documentation of all communications with medical office staff and/or MD provider is recorded in a timely and accurate manner
- May assist the Senior Medical Director in research activities/questions related to the Utilization Management process
- Participates in on-going training per inter-rater reliability process
Requirements:
- MD/DO/MBBS
- A clinical license, active and in good standing, in your home state is required
- Minimum of five (5) years’ experience in the practice of Medicine, post residency
- Active Clinical practice within the last 2 years is highly preferred
- Current, unrestricted clinical license in medicine or required specialty
- Obtaining and maintaining medical licenses in the state you reside, as well as, any license required per business needs
- Active Board Certification in Orthopedic Surgery
- Strong clinical, management, communication, and organizational skills
- Energetic and curious with a passion for quality and value in health care
- Computer Proficiency
- Not under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid
Benefits:
- Health insurance benefits
- Flexible work arrangements
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