Corporate Medical Director G&A
About this role
Description
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Become a part of our caring community
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The Corporate Medical Director provides clinical interpretation and makes determinations regarding the appropriateness of services delivered by other healthcare professionals, in accordance with established review policies, procedures, and performance standards. The Corporate Medical Director exercises independent judgment in addressing complex issues related to job responsibilities and associated tasks, applying critical analysis to variable factors and determining the most appropriate course of action.
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Provide medical interpretation and clinical judgment regarding the appropriateness, necessity, and quality of services rendered by other healthcare professionals.
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Perform or oversee clinical reviews of grievance and appeal cases for assigned markets, member populations, or condition-specific areas.
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