Prior Authorization Medical Director Opportunity in the Los Angeles Area
Please consider this unique opportunity to join a well-established and respected group of innovators in value-based care. This group of thought-leaders are in search of physician leaders to work alongside them to move the organization forward.
Requirements:
- MD/DO degree required
- Remote position, but candidate must live in the greater L.A. area for onsite meetings.
- Minimum of five years of prior clinical experience required, with at least two years of managed-care or health-plan experience preferred
About the Opportunity:
- Understand, promote, and manage the principles of medical management to facilitate the right care for patients at the right time and in the right setting.
- Review prior authorization requests for medical necessity using appropriate clinical guidelines.
- Identify high-risk patients and help coordinate care with the Employer s high-risk team.
- Participate in meetings to review, develop, and continually improve internal quality improvement and peer review processes and programs.
- Perform prior authorization functions for various Employer campuses, should the need arise in cross coverage, secondary/tertiary review, or medical director decision-making.
- Perform retroactive claims review for outpatient and inpatient care, as needed.
Compensation and Benefits:
- Competitive salary and aggressive incentives
- Comprehensive benefits including medical, dental, vision, and 401k
- Sign on bonus
- Ample paid time off
About the Area:
- Live in the entertainment capital of he world and enjoy dynamic mix of amenities that include outdoor adventures, fine dining, theme parks, the arts, world-class sports teams, and access to a major international airport
- Unmatched cultural amenities in one of the most diverse areas of the world
- Excellent public and private schooling options as highly respected colleges and universities
- World-class beaches and mountain resorts are within a short drive
- Enjoy a warm climate with over 300 sunny days a year
