Supplemental Assoc. Medical Dir

• * REMOTE & WEEKENDS ONLY **

Summary:

The Associate Medical Director provides support for Community Health Choice medical management programs. This includes performing medical necessity reviews, with peer-to-peer interactions as needed; appeals of adverse determinations.

Responsibilities: • The Associate Medical Director provides support for Community Health Choice medical management programs. • This includes performing medical necessity reviews, with peer-to-peer interactions as needed. • Appeals of adverse determinations.

Qualifications: • M.D. or D.O. Degree and Licensure in the State of Texas, Completion of Residency and Board Certification with preference for the Primary Care Specialties • Two (2) years prior managed care experience, to include proficiency in performing medical necessity reviews, benefit coverage reviews, and reviews of appeals of adverse determinations; Experience with STAR, CHIP and Health Insurance Marketplace programs preferred; Three (3)years clinical experience • Software Operated: Microsoft Office (Word, Excel, Outlook)

Preferred Skills:
• Communication Skills: Above Average Verbal (Heavy Public Contact) Exceptional Verbal (e.g., Public Speaking) Writing /Composing: Correspondence/Reports
• Other Skills: Analytical/Medical Terminology
• Advanced Education: Doctorate Major: M.D. or D.O.
• Work Schedule: Flexible

Pay range and compensation package - $84-$112 HOURLY

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