Medical Director – Neurologist

🔥 2 hours ago

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The Cigna Group

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10,000+ employees

🏥 Healthcare

🛡️ Insurance

Healthcare • Insurance

The Cigna Group is a global health services company that provides medical, dental, pharmacy, behavioral and supplemental insurance products and benefits to individuals, families, employers, brokers, providers and Medicare beneficiaries. It offers employer-sponsored group plans, individual and family plans (including Open Enrollment offerings), Medicare, international health insurance covering more than 200 countries, and digital member services through the myCigna platform (including telehealth and claims management). Its products are delivered through operating subsidiaries such as Cigna Health and Life Insurance Company and other regional affiliates.

📋 Description

• Performs benefit-driven medical necessity reviews for coverage, case management, and claims resolution • Works to achieve quality outcomes for customers/members with a focus on service and cost • Improves clinical outcomes through daily interactions with health care professionals • Balances customer/member needs with business needs while serving as a customer/member advocate • Participates in all levels of the Appeal process as appropriate • Participates in coverage guideline development and maintenance of medical management projects • Participates in quality processes such as audits and inter-rater reliability clinical reviews • Serves as a mentor or coach to other Medical Directors • Improves health care professional relations through direct communication • Addresses customer service issues with mentoring and support from leadership staff • Achieves internal customer satisfaction and regulatory compliance goals

🎯 Requirements

• Current unrestricted medical license in a US state or territory • Current board certification in an ABMS or AOA recognized specialty • Minimum of 5 years of clinical practice experience and/or direct patient care beyond residency • Computer Competency: Word processing, Spreadsheet, Email, PowerPoint and Personal Information Management programs • Must not be excluded from participation in any federal health care program • Must not be included in CMS’ Preclusion List

🏖️ Benefits

• Health-related benefits including medical, vision, dental • Well-being and behavioral health programs • 401(k) • Company paid life insurance • Tuition reimbursement • Minimum of 18 days of paid time off per year • Paid holidays