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Associate Medical Director Oncology MD DO Remote in Houston

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Job Ref:  311355985
Employer:  Network
Company Name:  Julia Edmunds Associates, Inc
Industry:  Healthcare other
Job Type:  Full Time
State:  Texas
City:  Houston
Zip Code:  77001

We are assisting in the search of an Associate Medical Director Board Certified in Medical Oncology (all adult care).This is a new position

Remote opportunity to be working from a home office anywhere in the USA!! Position offers a great work /life balance.

Must be available to work between the hours of 8AM-5PM- Monday- Friday. No nights, holidays or weekends!

Use your expertise to provide better outcomes for patients. Be part of a National Corporation servicing the needs of largest Healthcare plan in the country.

Chart /Utilization Reviews of new cases, appealed cases or reconsiderations- which may be peer to peer calls.

  1. Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States
  2. Review appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated.
  3. Provide timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions.
  4. Documents all actions related to clinical review sessions and attests to appeal review qualifications as required.

Maintains files of all reviews as required by law and Health Plans to retrieve reportable data.

Salary is $230,000 plus Bonus.

Comprehensive benefits package

Must have current clinical experience of at least 5 years in Medical Oncology.

Must be Board Certified

Must have an unrestricted license in a State or Territory in the USA.

Knowledge of applicable state and federal laws, URAC and NCQA standards

Can work remotely from any location in the USA! Must complete 2 weeks of training in Florida.

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