✨ About The Role
- The Medical Director (Spine) will serve as a Subject Matter Expert (SME) in their field, providing clinical expertise and business direction.
- This role involves leading utilization review and quality assurance processes, ensuring effective case management.
- The Medical Director will support medical management staff in delivering timely responses to members and providers.
- Responsibilities include conducting predetermination reviews and assessments of claim determinations.
- The position requires collaboration with network providers and facilities to enhance the execution of medical services programs.
âš¡ Requirements
- The ideal candidate will have a strong background in Orthopedic Spine or Neurosurgery, with direct patient care experience.
- A minimum of 2 years of experience in the healthcare delivery system is essential for this role.
- Candidates should possess an active and current state medical license without any encumbrances.
- Board certification in Orthopedic Spine or Neurosurgery is required, indicating a high level of expertise in the field.
- Previous experience in healthcare insurance is preferred, showcasing an understanding of the insurance landscape.