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Academic/Faculty/Research Physician

Company

Med Ninjas

Location

Texas, Dallas

Type

Permanent

Job Description:
The Associate Medical Director at Parkland Community Health Plan will take a hands-on approach in overseeing and supporting clinical activities, ensuring the delivery of comprehensive care to PCHP members. This need will be FULLY remote while the provider is working locums, but they will need to transition to a hybrid model once they go perm.

This is a 13-week locum assignment with the hope that the provider will transition into a permanent role.

Responsibilities:

  • Reviews prior authorization and appeals request for approval or denial of claims payment based on medical necessity.
  • Performs peer to peer calls as necessary to support the utilization management process.
  • Provides clinical oversight for utilization management, disease management and quality management activities as assigned by the PCHP Chief Medical Officer or Sr. Medical Director including participation in development of medical policies...

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