Orthopedic Spine Surgeon Medical Director
Company: VirtualVocations
Location: Newark
Posted on: January 28, 2025
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Job Description:
A company is looking for an Appeals and Grievances Medical
Director - Orthopedic or Neurological Spine Surgeon.
Key Responsibilities
Conduct clinical reviews and adjudications of appeals and
grievances for various health plan products
Respond to regulatory inquiries from the Department of Insurance,
Department of Managed Healthcare, and CMS
Collaborate with medical directors and network management on
access, quality, and benefit interpretation issues
Required Qualifications
MD or DO with an active, unrestricted license
Board Certified Orthopedic or Neurological Spine Surgeon
5+ years of clinical practice experience
2+ years of Quality Management experience
Intermediate proficiency with managed care
Keywords: VirtualVocations, East Orange , Orthopedic Spine Surgeon Medical Director, Executive , Newark, New Jersey
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