Associate Medical Director - Medical Oncology
Associate Medical Director Board Certified in Medical Oncology or Board Certified Hematology/Oncology
- Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria.
- Review appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated.
- Provide timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions.
- 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.
- This role will have you working with the Radiology/ Imaging Department. You will be asked to see imaging cases in addition to Med Oncology cases. Must be open and flexible to both.
The MD will have client's evidence based guidelines to lean on for cases outside of their specialty, and will be assigned a mentor to answer any and all questions they may have as they are getting underway in their role.
Full time hours would be SET daily schedule from 8a-5p. Full time salary for this role $230,000, and includes a full comprehensive benefits package
Part time hours is considered anything between 20-30 hours per week. The salary is prorated, based on the number of hours worked.
*** Incentives! WHAT IS IN IT FOR YOU!!
- Annual personal and company performance based bonus potential
- Per case cash incentives to review more cases in busy times.
- Flexible scheduling and work/life balance with remote and work from home opportunities
- 4 weeks of PTO(starting) per year plus paid holidays
- Ample opportunities for growth, advancement, and promotion
- 401k retirement plan with company match of 50% employee contributions up to 6%
- And more!
- Current clinical experience of at least 5 years in Medical Oncology or Hematology/ Oncology.
- Active and unrestricted license to practice medicine in a state or territory of the United States as a utilization review doctor of medicine or doctor of osteopathic medicine
- Knowledge of applicable state and federal laws, URAC and NCQA standards.
- Familiarity with automated processes and computer applications and systems required.
- Board certified through the ABMS
- MUST have an ACTIVE license in one of the following states: AR, LA, MA, OR, MO, AK, KY, MA, AZ, CA, GA, MD, NV, NH, WA and WI