Plan Performance Medical Director - Waukesha, WI
2 weeks ago

Job summary
The Plan Performance Medical Director serves as a lead clinician and oversees the administration of medical services for individual ACA health plans across 17 states.
- Supports the Medical Management staff to ensure timely and consistent responses to members and providers.
- Provides guidance for clinical operational aspects of a program.
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Responsibilities
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- Conducts peer-to-peer clinical reviews with attending physicians or other providers to discuss review determinations, li>,
- Makes decisions related to medical policies and guidelines, li>,
Job description
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