Medical Director

Job not on LinkedIn

🕒 June 25

🇺🇸 United States – Remote

💵 $195.2k - $341.6k / year

⏰ Full Time

🔴 Lead

👨‍⚕️ Medical Director

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

CareSource

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 30+ years

⚕️ Healthcare Insurance

Healthcare Insurance

CareSource is a health services company focused on providing affordable health insurance and healthcare solutions. It offers a wide range of plans including Medicaid, Marketplace, and Medicare Advantage, targeting low-income adults, families, children, pregnant women, elderly adults, and people with disabilities. Additionally, CareSource provides members with resources for COVID-19 support, dental, vision, and hearing benefits, as well as pharmacy services. The company emphasizes easy access to healthcare management through online platforms and a mobile app.

📋 Description

• Perform medical necessity review of appeals • Administer the decision-making process related to appeals • Support clinical operations and facilitate communication among stakeholders • Review and make determinations on complex clinical appeals • Provide clinical expertise and guidance in the evaluation of appeals • Collaborate with cross functioning teams • Support the development and implementation of clinical guidelines and protocols • Serve as a liaison between the organization and stakeholders • Participate in quality assurance initiatives • Stay current with industry trends, regulations, and best practices

🎯 Requirements

• Doctoral Medical degree (MD or DO) from an accredited institution required • Bachelor's or Master's degree in Business Administration, Healthcare Administration or Medical Management preferred • Successful completion of a residency training program required • Five (5) years Clinical practice experience required • Five (5) years Managed care medical review/medical director experience preferred • Excellent verbal and written communication skills • Clinical decision making • Healthcare policy knowledge • Appeals processing • Stakeholder communication • Medical expertise • Outcomes improvement • Policy adherence • Familiarity with medical necessity criteria and clinical guidelines

🏖️ Benefits

• Health insurance • Retirement plans • Paid time off • Flexible work arrangements • Professional development • Bonuses