Associate Medical Director - Orthopedic Spine

The Clinical Operations Associate Medical Director - Orthopedic Spine Surgery is responsible for performing pre-authorizations and providing quality improvement solutions for musculoskeletal procedures involving the spine and/or joints, and high-tech diagnostic imaging.

• Determines the medical necessity of requests using clinical criteria
• Performs physician-level case review of musculoskeletal utilization requests
• Conducts peer-to-peer consultation with ordering physicians, physician assistants and advanced practice nurses
• Provides education regarding applicable clinical criteria and discusses clinically appropriate alternative surgical and non-surgical treatments
• Performs first level provider appeals of coverage decisions
• Provides support and education to internal clinical and non-clinical staff
• Participates in physician team meetings
• Participates in groups that develop, revise and enhance clinical appropriateness guidelines

• MD or DO and Board certification by the American Board of Orthopedic Surgery or American Osteopathic Board of Orthopedic Surgery
• Current unrestricted medical license(s) as a Doctor of Medicine or Doctor of Osteopathic Medicine in appropriate state(s)
• Experience performing standard neurosurgical spine procedures independently
• Minimum of 3 years of clinical practice experience past fellowship training preferred
• Extensive spine surgery experience preferred
• Experience with utilization management, especially with CMS guidelines preferred
• Orthopedic Spine Fellowship completion strongly preferred

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution
• Short and long term disability benefits
• Wellness programs
• Financial education resources

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