Associate Medical Director, Utilization Management
New
O
Oscar HealthHealth Insurance
Open to candidates holding an active medical license in Florida, Arizona or North Carolina, OR to physicians who hold an IMLC compact licenseFull-TimeManager
Salary240,120 - 315,157 USD per year
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Job Details
- Experience
- 3+ years of clinical practice; 2+ years of utilization review experience
Requirements
- Board certification as an MD or DO.
- Current unrestricted license to practice medicine.
- 3+ years of clinical practice.
- 2+ years of utilization review experience in a managed care plan.
- Active medical license in FL, AZ, or NC, or IMLC compact license.
- Willingness to obtain additional state licensure.
Responsibilities
- Provide timely medical reviews that meet quality parameters.
- Provide clinical determinations based on evidence-based criteria and internal guidelines.
- Document communication and decision-making in workflow tools.
- Conduct peer-to-peer discussions with treating providers.
- Manage direct reports and oversee performance.
- Provide oversight to ensure team meets turn-around times.
- Collaborate with other departments on Utilization Management Operations.
- Lead key projects and initiatives.
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