About this opportunity
Health Care Partners lists this Medical Director, Utilization & Quality Review opportunity in village of garden city, New York. Review the employer’s description below for duties, qualifications and application requirements.
Job description
HealthCare Partners is seeking a Medical Director – UM Reviewer to ensure appropriate and optimized care for members. This role conducts medical necessity reviews, including prior authorizations, concurrent and retrospective reviews, and appeals determinations.
The position collaborates with IPA physicians and cross-functional teams to improve cost management, quality, and outcomes. Requires MD/DO, board certification, NY license, 5 years clinical practice and 2+ years in managed care; base
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Who can apply
Review the original listing for work authorization, qualifications and employer requirements.