Medical Director - Radiology

6 days ago

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Premier Inc.

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healthcare and healthtech

1001 - 5000

Description

• Responsible for processing UM requests, appeals, and reconsiderations. • Required to write a denial rationale in compliance with health plan and government agencies. • Required to be compliant with contractual obligations to the health plans and government agencies, and certifications maintained by Care to Care. • Required to participate in quarterly UM meetings. • Responsible for identifying educational needs and participating in ongoing education and support for the medical and intake staff. • Acts as a clinical liaison to providers, clients, and patients as directed by the Chief Medical Officer. • Communicates need for additional clinical information to referring/prescribing providers. • Collaborates with management to create and implement new process or quality improvement initiatives. • Coordinates with UM Intake Specialists to ensure timely communication of clinical decisions. • Collaborates with clinical team to review and update clinical criteria guidelines at least annually.

Requirements

• NY, NM and/or CA medical license is required • Must be a Board-Certified Radiologist • 7 or more years of applicable experience • MD in Medicine required • Strong clinical, management and organizational skills • Excellent verbal and written communications skills • Proficient computer skills • High degree of personal integrity and ethical conduct • Experience with regulatory requirements

Benefits

• Health, dental, vision, life and disability insurance • 401k retirement program • Paid time off • Participation in Premier’s employee incentive plans • Tuition reimbursement and professional development opportunities