Medical Director - Orthopedic Surgery - Remote

Lensa; Dallas (TX); Remote; USD 238,000 - 358,000; Full time

Job summary

A leading healthcare company is seeking a Medical Director for Orthopedic Surgery to provide physician support and ensure high-quality medical care. This remote role involves clinical reviews, collaboration with providers, and adherence to policies. Candidates should have an M.D. or D.O. with board certification and at least 5 years of clinical experience. The position emphasizes diversity and health equity, offering a competitive salary and benefits.

Qualifications

• At least 5 years of clinical practice post-residency.
• Ability to participate in holiday and call rotations.

Responsibilities

• Conduct coverage reviews based on member benefits and policies.
• Document review findings in compliance with policies and regulations.
• Engage in peer-to-peer discussions with requesting providers.

Skills

Knowledge of Evidence-Based Medicine

Excellent communication skills

Data analysis and interpretation

Problem-solving abilities

Education

M.D. or D.O. with Board certification in Orthopedic Surgery

Active unrestricted medical license

Tools

MS Word

Outlook

Excel

Job description

Medical Director - Orthopedic Surgery - Remote

Position Overview: The Medical Director provides physician support to Enterprise Clinical Services, focusing on clinical review and benefit determinations for members. This role involves collaboration with healthcare providers, ensuring the delivery of cost-effective, high-quality medical care, and adherence to policies and regulations.

Primary Responsibilities:

1. Conduct coverage reviews based on member benefits and policies, making determinations accordingly.
2. Document review findings in compliance with policies and regulations.
3. Engage in peer-to-peer discussions with requesting providers as needed.
4. Interpret benefit language and policies during clinical reviews.
5. Participate in daily clinical rounds and collaborate with providers and internal teams.
6. Communicate benefit determinations clearly and educate providers on policies.
7. Participate in holiday and call coverage rotations.
8. Obtain additional licenses as required.

Qualifications:

• M.D. or D.O. with Board certification in Orthopedic Surgery.
• Active unrestricted medical license.
• At least 5 years of clinical practice post-residency.
• Knowledge of Evidence-Based Medicine.
• Proficiency in MS Word, Outlook, and Excel.
• Ability to participate in holiday and call rotations.

Preferred Skills:

• Experience in utilization review and clinical coverage.
• Excellent communication and facilitation skills.
• Data analysis and interpretation skills.
• Strong problem-solving abilities.
• Presentation skills for diverse audiences.

Additional Details: This is a remote position within the U.S., with a salary range of $238,000 to $357,500, plus benefits. The role emphasizes diversity, inclusion, and health equity. The application deadline is at least 2 business days from posting, subject to early closing based on applicant volume.