Associate Medical Director (30119)

The Associate Medical Director will be responsible for providing medical oversight and leadership for the organization’s medical review process. The position will work alongside the Medical Director and other team members to ensure all reviews are conducted accurately and efficiently.

Essential Job Functions

• Develop, maintain and oversee the medical review process, ensuring policy and procedure compliance, quality and efficiency
• Assist in the recruitment, training and management of reviewers to ensure they meet the necessary qualifications
• Review appeals or complaints that relate to medical review decisions
• Evaluate and respond to inquiries from physicians, providers, and clients
• Act as the medical resource, providing guidance and support to the business units
• Collaborate with the Medical Director and senior management to ensure coordination of strategy
• Recommend and implement quality assurance measures to improve peer review processes
• Communicate recommendations and decisions regarding review findings to relevant stakeholders
• Serve as a standing active member of the credentialing committee
• Review, provide input, and approve all policies and procedures related to the clinical aspects of the program

• MD, DO, or DPM degree required
• Current, active unrestricted license to practice medicine required
• Minimum of five years of experience in peer review management or a similar medical quality-based function
• Board Certification in an ABMS or AOA-recognized specialty required if an MD or DO
• Ability to provide clinical guidance regarding the quality and/or clinical aspects of reviews and, when appropriate, directly communicates with reviewers, staff, and/or clients
• Ability to travel as required
• Ability to interact with clients as needed, either independently or as a participating member of a group discussion between service and client, regarding the clinical quality aspects of the medical reviews
• Must have strong knowledge of medical terminology and procedures, which may include utilization reviews, quality-assurance services compliance and claims analysis
• Ability to ensure the organizational objective to have qualified reviewers accountable to the organization for decisions impacting clients, when applicable. 
• Must have an adaptable, and collaborative management style
• Must have knowledge of federal and/or state legislative mandates (ERISA and/or state law)
• Ability to follow all company policies and procedures in effect at time of hire and as they may change or be added from time to time

Who We Are

ExamWorks is a leading provider of innovative healthcare services including independent medical examinations, peer reviews, bill reviews, Medicare compliance, case management, record retrieval, document management and related services. Our clients include property and casualty insurance carriers, law firms, third-party claim administrators and government agencies that use independent services to confirm the veracity of claims by sick or injured individuals under automotive, disability, liability and workers' compensation insurance coverages.

ExamWorks, LLC is an Equal Opportunity Employer and affords equal opportunity to all qualified applicants for all positions without regard to protected veteran status, qualified individuals with disabilities and all individuals without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age or any other status protected under local, state or federal laws.

Equal Opportunity Employer - Minorities/Females/Disabled/Veterans