Medical Director - Pharmacy Appeals

A company is looking for a Medical Director - Pharmacy Appeals to review Medicare drug appeals.



Key Responsibilities

Review moderately complex to complex Medicare drug appeals for coverage
Collaborate with clinicians and support staff to ensure optimal value-based care
Participate in Peer to Peer discussions with prescribers and support CMS audits


Required Qualifications

MD or DO degree
5+ years of direct clinical patient care experience post-residency or fellowship
Current and ongoing Board Certification in Internal Medicine, Family Medicine, Emergency Medicine, or Physical Medicine and Rehabilitation
A current and unrestricted medical license in at least one jurisdiction
No current sanctions from Federal or State Governmental organizations