What are the responsibilities and job description for the Appeals M.D. - Remote, Board-Certified Med-Peds or FM position at The VIOS Clinic?
The Appeals and Grievances Medical Director is responsible for clinical review and adjudication of appeals and grievances related to medical services, benefit design, and coverage across various health plans.
They perform case reviews, handle regulatory responses, and communicate decision rationales with internal teams and external agencies.
The role involves participating in team meetings, providing clinical and strategic input on organizational initiatives, and ensuring quality and access issues are addressed.
Qualifications include an MD or DO with an active license, board certification in a non-pediatric specialty, and at least 5 years of clinical practice.
Preferred skills encompass quality management, managed care proficiency, project management, data analysis, presentation abilities, and teamwork.
This remote position offers a competitive salary and benefits, with a focus on improving healthcare quality and equity.
They perform case reviews, handle regulatory responses, and communicate decision rationales with internal teams and external agencies.
The role involves participating in team meetings, providing clinical and strategic input on organizational initiatives, and ensuring quality and access issues are addressed.
Qualifications include an MD or DO with an active license, board certification in a non-pediatric specialty, and at least 5 years of clinical practice.
Preferred skills encompass quality management, managed care proficiency, project management, data analysis, presentation abilities, and teamwork.
This remote position offers a competitive salary and benefits, with a focus on improving healthcare quality and equity.