Medical Director at ISLAND PEER REVIEW ORGANIZATION INC

, , United States -

Full Time

Start Date

Immediate

Expiry Date

07 Aug, 26

Salary

150.0

Posted On

09 May, 26

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Clinical Overview, Medical Appeal Decisions, Credentialing, Specialty Recruiting, Compliance Management, Problem Solving, Collaborative Work, Time Management, URAC Compliance, ISO Training Requirements

Industry

Description

Job Description The Medical Director is responsible for providing final clinical overview and signed authorization of medical appeal decisions. The physician will direct the oversight of the physician panel, provide input in decision on credentialing and specialty recruiting and work closely with multiple departments who manage appeals operations. Oversight will include: * Providing clinical input on decision complaints * Consulting with individual physicians on decisions and concerns * Reviewing each decision with care to ensure that the case has been reviewed by the appropriate specialty match * Providing hands on program guidance and support to directors, including reporting metrics and contract deliverables * Coordination to maintain compliance with URAC/ISO training requirements This position is remote and can be based anywhere in the U.S. - Role is 32 hours per week - Monday - Thursday QUALIFICATIONS * Must hold a current, active, and unrestricted professional license in the U.S. in a recognized discipline * Maintain licensure in good standing with no active sanctions or disciplinary restrictions * Must be a strong problem solver that works collaboratively with peers and other staff * Ability to work independently with minimal supervision and as part of a team. * Must be able to meet deadlines in a time sensitive environment including off hours coverage EDUCATION & EXPERIENCE * Medical Degree as DO or MD * Board Certification in an identified specialty * 5+ years of post licensure clinical experience in direct patient care The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. The salary range and/or hourly rate listed does not include other forms of compensation or benefits. IPRO is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or military status, or any other category protected under applicable law.

Responsibilities

The Medical Director provides final clinical overview and authorization for medical appeal decisions while overseeing a physician panel. They are responsible for ensuring specialty match accuracy, providing program guidance to directors, and maintaining URAC/ISO compliance.