Medical Director - Riverside

Only for registered members Riverside, United States

1 month ago

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Job Summary

Provides medical oversight and expertise in appropriateness and medical necessity of services provided to members targeting improvements in efficiency and satisfaction for both members and providers ensuring members receive the most appropriate care in the most effective setting.

Responsibilities

  • Determines appropriateness and medical necessity of health care services provided to plan members.
  • Evaluates effectiveness of utilization management UM practices actively monitoring for over and under-utilization.

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