Job Description

Prior Authorization Medical Director Physician 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

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