Medical Director - Clinical Advocacy
Company: VirtualVocations
Location: Vista
Posted on: May 20, 2025
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Job Description:
A company is looking for a Medical Director - Clinical Advocacy
and Support with a preference for ENT or Internal Medicine.
Key Responsibilities
Conduct coverage reviews and render coverage determinations based
on member plan benefits
Document clinical review findings in accordance with policies and
regulatory requirements
Engage in peer-to-peer discussions with requesting providers and
collaborate with network and non-network providers
Required Qualifications
M.D. or D.O. degree
Active unrestricted license to practice medicine
Board certification in an ABMS specialty, preferably in Internal
Medicine, ENT, Hematology-Oncology, General Surgery, Rheumatology,
or PM&R
3+ years of clinical practice experience post-residency
Demonstrated understanding of Evidence Based Medicine (EBM)
Keywords: VirtualVocations, Poway , Medical Director - Clinical Advocacy, Executive , Vista, California
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