Medical Director (Cardiology)

• Support the Medical Management staff ensuring timely and consistent responses to members and providers
• Lead all aspects of utilization review/quality assurance, directing case management
• Provide clinical expertise and business direction in support of medical management programs through participation in clinical team activities
• Act as lead business and clinical liaison to network providers and facilities to support the effective execution of medical services programs by the clinical teams
• Responsible for predetermination reviews and reviews of claim determinations, providing clinical, coding, and reimbursement expertise

• 2 or more years of experience in Health Care Delivery System e.g., Clinical Practice and Health Care Industry
• Active and current state medical license without encumbrances
• M.D. or D.O., Board Certification in Cardiology specialty including post-graduate direct patient care experience specifically

Previous healthcare insurance experience

• Full range of medical, dental, and vision benefits
• 401(k) retirement savings plan
• Employee Stock Purchase Plan
• Fully-paid term life insurance plan
• Short-term and long-term disability benefits
• Well-being programs
• Education assistance
• Free development courses
• CVS store discount
• Discount programs with participating partners
• Paid Time Off (PTO) or vacation pay
• Paid holidays