Medical Director – Oncology

Role Overview

• Responsible for appeal reviews for physical health medical services
• Ensure the appropriate and most cost-effective medical care is received
• Develop and implement programs to improve quality, cost, and outcomes
• Provide clinical consultation and serve as clinical/strategic advisor to enhance clinical operations
• Identify cost of care opportunities
• Supports clinicians to ensure timely and consistent responses to members and providers
• Provides guidance for clinical operational aspects of a program
• Conduct peer-to-peer clinical case reviews with attending physicians or other ordering providers
• Serve as a resource and consultant for other areas of the company

Requirements

• Requires MD or DO and Board certification approved by American Board of Medical Specialties (ABMS) or American Osteopathic Association (AOA)
• Must possess an active unrestricted medical license to practice medicine or a health profession
• Minimum of 10 years of clinical experience; or any combination of education and experience that would provide an equivalent background
• For Health Solutions and Carelon organizations, minimum of 5 years of experience providing health care is required
• Board certification in Oncology or Hematology and Oncology strongly preferred
• Utilization Management or Appeals experience preferred

Benefits

• comprehensive benefits package
• incentive and recognition programs
• equity stock purchase
• 401k contribution
• merit increases
• paid holidays
• Paid Time Off
• medical benefits
• dental benefits
• vision benefits
• short and long term disability benefits
• wellness programs
• financial education resources