California Licensed Cardiology Medical Director

Job Summary

A company is looking for an Appeals M.D. - Cardiology.

Key Responsibilities

• Conduct individual case reviews for appeals and grievances related to various health plan products
• Engage with medical directors and staff regarding appeals decisions and network issues
• Participate in team meetings and provide clinical input for organizational committees and projects

Required Qualifications

• MD or DO with an active, unrestricted license
• Board Certified Cardiologist in an ABMS or AOBMS specialty
• 5+ years of clinical practice experience
• 2+ years of Quality Management experience
• Intermediate proficiency with managed care