Provides administrative oversight to the medical staff
Analyzes medical review utilization data
Researches new medical procedures or technology
Acts as a resource to providers and internal staff on medical policies
May write and revise medical policies
Develops claim adjudication criteria
Provides input on operational policies, processes, and procedures
Educates staff and medical community on medical policy and program administration
Develops external relationships with the medical community
Reviews physician and provider practice pattern analysis and other statistical data
Conducts research into new or controversial medical procedures and technology

Doctorate degree
Medical Doctor (MD) with current active license to practice medicine
Active state medical license and current board certification in a recognized specialty
Five years post graduate experience in direct patient care
Excellent verbal and written communication skills
Excellent customer service, organizational, and presentation skills
Proficiency in spelling, punctuation, and grammar
Ability to persuade, negotiate, or influence others
Knowledge of medical and utilization review techniques
Experience interpreting medical evidence
Scientific training/Research experience with publication history in Molecular Diagnostics
Microsoft Office Suite

Molecular Diagnostics Medical Director

Key skills