Associate Medical Director- DMEPOS
Core
Board-certified physician providing clinical case reviews, physician-to-physician consultations, and medical necessity determinations for DMEPOS services.
Role type
Associate Medical Director (Clinical Operations)
Builds
Medical necessity decisions and clinical case reviews for DMEPOS members and providers
Domain
Healthcare / Medical Management / Durable Medical Equipment
Required skills
Board certification (ABMS/AOA), Active unrestricted medical license, Clinical case review expertise, Physician-to-physician communication, Medical policy interpretation
Preferred skills
Board certification in Family Medicine, Internal Medicine, or PM&R, Additional state licensure
Technologies
None stated
Responsibilities
Ensure timely completion of clinical case reviews, Make physician-to-physician calls for medical necessity determinations, Make medical necessity determinations for grievances and appeals, Ensure consistent use of medical policies, Escalate complex cases requiring Medical Director review
Seniority
Non-Management Non-Exempt
