California Licensed Oncologist 3093011 I.Html

To support ongoing clinical review and adjudication of appeals and grievances, a California Licensed Oncologist will work remotely in a full-time capacity, managing individual case reviews for various health plan products and collaborating with medical directors on decision rationales.

##### Key responsibilities

Perform individual case reviews for appeals and grievances related to medical services and benefit coverage

Communicate with medical directors regarding appeals decision rationales and benefit interpretations

Participate in team meetings focused on process improvement, feedback, and program results sharing

##### Required qualifications

MD or DO with an active, unrestricted license

Board Certified in an ABMS or AOBMS specialty

5+ years of clinical practice experience

2+ years of Quality Management experience

Intermediate proficiency with managed care