Opportunity Description
Position Type
Full-Time/Regular
It’s an exciting time to join the WellSense Health Plan, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances.
**Job Summary:**
The Medical Director will report to the Senior Medical Director of Utilization Management, Member Appeals & Grievances, and Medical Policy (Senior Medical Director of Utilization Management) and support the staff of the Office of Clinical Affairs in the areas of medical management daily medical necessity reviews, evaluation of medical policy, utilization trend management, quality, appeals and grievances, and pharmacy reviews.
Our Investment in You:
· Full-time remote work
· Competitive salaries
· Excellent benefits
**Key Functions/Responsibilities:**
· Provides clinical case review, consultation and oversight for all utili...
Full-Time/Regular
It’s an exciting time to join the WellSense Health Plan, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances.
**Job Summary:**
The Medical Director will report to the Senior Medical Director of Utilization Management, Member Appeals & Grievances, and Medical Policy (Senior Medical Director of Utilization Management) and support the staff of the Office of Clinical Affairs in the areas of medical management daily medical necessity reviews, evaluation of medical policy, utilization trend management, quality, appeals and grievances, and pharmacy reviews.
Our Investment in You:
· Full-time remote work
· Competitive salaries
· Excellent benefits
**Key Functions/Responsibilities:**
· Provides clinical case review, consultation and oversight for all utili...
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