Pennsylvania Licensed Medical Director - job 1 of 2

Job Summary

A company is looking for a Medical Director, Grievances.

Key Responsibilities

• Provide leadership direction for provider credentialing processes
• Ensure timely medical decisions and participate in quality improvement and care management goals
• Communicate clinical guidelines and represent the Health Plan in external accreditation activities

Required Qualifications

• Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) from an accredited school
• Active Pennsylvania Medical License
• Board certification in a relevant medical specialty
• Experience in quality improvement and utilization management
• Ability to work remotely for 10-18 hours per week