Medical Director (Ortho/Total Joint)

Responsibilities

• Lead utilization review and quality assurance processes
• Direct case management activities
• Support Medical Management staff with member and provider inquiries
• Provide clinical expertise in medical management programs
• Act as liaison between clinical teams and network providers
• Conduct predetermination and claim determination reviews

Qualifications

• 2+ years in Health Care Delivery System (Clinical Practice/Health Care Industry)
• Active and current state medical license without encumbrances
• M.D. or D.O. with Board Certification in Orthopedic specialty
• Post-graduate direct patient care experience in orthopedics

Benefits

• Comprehensive medical, dental, and vision coverage
• Paid time off
• Retirement savings options
• Access to wellness programs
• Resources for physical, emotional, and financial well-being

Our Client

Our client is an equal opportunity employer. We encourage you to apply even if you don’t meet every qualification—your background could be exactly what this team needs.